Candidate S.F. Zadvoryev^{1, 2}
PhD, Associate Professor L.V. Lyuik³
Dr.Med., Professor O.B. Krysyuk^{2, 4}
Dr.Med., Professor A.G. Obrezan^{2, 4
1}City diversified hospital № 2, St. Petersburg
²St. Petersburg State University, St. Petersburg
³St. Petersburg Polytechnic University named after Peter the Great, St. Petersburg
⁴International Medical Center "Sogaz", St. Petersburg

Objective of the study was to assess the prevalence of significant electrocardiogram anomalies and the prognostic value of the existing risk of sudden death in highly-skilled football players.
Methods and structure of the study. We carried out a prospective cohort study to determine the incidence of the electrocardiogram patterns of high risk of sudden cardiac death based on the data obtained in the Russian highly-skilled athletes, members of the men's professional football teams (n=65, mean age - 23.3±6.4 years). During the survey, we determined the incidence of significant and insignificant heart rate and cardiac conductivity disorders according to the electrocardiogram data, as well as the dynamics of sports career during the 3-year follow-up period.
Study results and conclusions. The electrocardiogram changes (when analyzed on ACCF 2009 recommendations) were found in 80% of the subjects (52 athletes), while 74% of them (59% of the total number, or 38 athletes) were regarded as non-pathological according to all the risk criteria of sudden cardiac death. The total prevalence of abnormal electrocardiogram equaled 21% for ESC and 15% for Stanford criteria and their derivatives - "refined criteria" (TP=0.72, p=0.046). Abnormal electrocardiogram changes were associated with the transition to a sports club of a higher skill level (from a duplicate team to the main or from a lower division team to a higher one) for 3 years of prospective study. The rate of skill improvement in the patients with abnormal electrocardiogram was 60%, in those with normal electrocardiogram - 20% (p=0.042). There were no reported sudden deaths during 3 years of prospective study.
In highly-skilled football players, the electrocardiogram pattern of high risk of sudden cardiac death can be due to the growth of their sports skills.

Keywords: sports cardiology, sudden cardiac death, electrocardiogram, arrhythmia, cardiac conduction disorders.

References

1. Grigor’ev V.I., Piskun O.E., Ivanov V.M. Perspektivy razvitiya sportivnoy nauki v rossiyskikh vuzakh [Perspectives of Development of Sport Science in Russian Universities Teoriya i praktika fiz. Kultury, 2015. No. 2. pp. 34-36.
2. Revishvili A.Sh. , Neminushchiy N.M., Batalov R.E. et al. Vserossiyskie klinicheskie rekomendatsii po kontrolyu nad riskom vnezapnoy ostanovki serdtsa i vnezapnoy serdechnoy smerti, profilaktike i okazaniyu pervoy pomoshchi [National clinical guidelines for sudden cardiac arrest and sudden cardiac death risk control, prevention and first aid]. Vestnik aritmologii. 2017. No. 89. 104 p.
3. Filippov S.S., Piskun O.E. Organizatsionno¬-pravovoe obespechenie deyatelnosti sportivnykh klubov obrazovatelnykh organizatsiy [Organizational ¬Legal Support of Activity of Sports Clubs of Educational Establishments]. Teoriya i praktika fiz. kultury. 2014. no.7. pp. 52¬55.
4. Bakayev V.V., Bolotin A.E., Chunguang You (2018), “Reaction of vegetative nervous system to loads in female long - distance runners with different fitness level”,  Journal of Human Sport and Exercise, (JHSE) 2018, 13(2),   pp. 245-252.
5. Bakayev V.V., Bolotin A.E., Aganov  S.S. (2018), “Сomparative analysis of the changes in blood chemistry among long-distance swimmers during workouts at middle and low altitudes”,  World congress of performance analysis of sport XII ( 19-23 September, 2018, Opatija, Croatia), pp.39-42.
6. Bolotin A.E., Bakayev V.V. (2017), “Method for training of long distance runners taking into account bioenergetic types of energy provision for muscular activity”,  5-th International Congress on sport sciences research and technology support (icSPORTS 2017) (30-31 Oktober, 2017, Funchal, Madeira, Portugal), pp.126-131.
7. Bolotin A.E., Bakayev V.V. (2018), “Scientific and theoretical prerequisites for improvement of modern pedagogical technologies”, In book: Advanced Learning and Teaching Environments – Innovation, Contents and Methods – Publisher: IntechOpen, 2018, pp. 195-221.
8. Bolotin А. Е., Bakayev V. V. Peripheral circulation indicators in veteran trail runners. Journal of Physical Therapy Science, (JPТS) Vol. 29 (2017), No.6, pp.1092-1094.
9. Bolotin А. Е., Bakayev V. V. Response of the respiratory system of long and middle distance runners to exercises of different types. Journal of Physical Education and Sport (JPES), 2017. -  17(5), Art.231, pp.2214-2217.
10. Bolotin A.E., Bakayev V.V., Orlova N.V. and Kozulka A.N. (2017), “Peculiarities of time structure and of biomechanical organization of a construction of motor actions in the hammer throw”,  8-th International scientific conference on kinesiology (May 10-14, 2017, Opatija, Croatia), pp.137-141.
11. Bolotin A.E., Bakayev V.V. (2018), “Training process modeling of hammer throwers taking into account peculiarities of stress adaptation”, icSPORTS 2018 Proceedings of the 6-th International Congress on sport sciences research and technology support. (20-21 September, 2018, Seville, Spain), pp.79-84.
12. Zorzi A., el Maghawry M., Corrado D.  Evolving interpretation of the athlete's electrocardiogram: from European Society of Cardiology and Stanford criteria, to Seattle criteria and beyond. J Electrocardiol. 2015. Vol. 48(3). pp.283-291.