{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T17:40:44Z","timestamp":1786642844982,"version":"build-2736575974"},"reference-count":37,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Medical Research Council fellowship","award":["MR\/W025167\/2"],"award-info":[{"award-number":["MR\/W025167\/2"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2026,7,31]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the diagnostic yield and clinical implications of so-called \u2018borderline\u2019 ECG findings and ectopic beats in elite football players, in accordance with the 2017 International Criteria (IC17) for ECG interpretation in athletes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 17\u2009685 professional footballers (84.7% males) underwent cardiac screening including a 12-lead ECG and echocardiography between 2017 and 2024. Borderline ECG changes were classified according to the IC17. Supraventricular and ventricular ectopic beats were also analysed. Prevalence of cardiac pathology (major and minor) among athletes with borderline changes was compared with those athletes with normal ECGs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Borderline ECG findings were present in 1389 (7.9%) athletes (8.8% males, 2.6% females; p&lt;0.001), with right atrial enlargement being the most frequently observed pattern (5.5%). Major cardiac pathology was incidentally identified in 2 (1.43%) athletes with isolated left atrial enlargement, compared with 9 (0.06%) athletes with normal ECGs (p=0.004), including 1 case of an anomalous coronary origin and another case with significant aortic root dilatation\u2014both unrelated to the ECG findings. All other borderline patterns as well as ectopy did not reveal any major pathology. No major conditions were identified in 42 athletes with isolated \u22652 borderline ECG findings. Minor cardiac pathology was identified in 18 (1.41%) athletes with isolated borderline findings and in 3 (2.07%) athletes with isolated ectopy. When \u22652 borderline findings were present, 2.38% athletes revealed minor pathology (p=0.463). Minor cardiac pathology was found in 212 (1.34%) of athletes with normal ECGs (p=0.836).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Borderline ECG criteria in the IC17 and ventricular ectopy are poor discriminators for major and minor cardiac pathology in athletes. Borderline changes including \u22652 findings do not warrant further evaluation and could be considered normal findings in future iterations of ECG interpretation criteria in athletes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2026-111868","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T17:20:16Z","timestamp":1786641616000},"page":"bjsports-2026-111868","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic yield of borderline ECG changes and ectopic beats in football players"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4124-6421","authenticated-orcid":false,"given":"Kentaro","family":"Yamagata","sequence":"first","affiliation":[{"name":"School of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, 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