Background Athlete cardiac screening for conditions associated with sudden cardiac death is recommended by international bodies. High Performance Sport New Zealand (HPSNZ) commenced screening elite Olympic-sport athletes in 2012. Aim To report findings from the HPSNZ cardiac screening program, including comparisons between sexes and ethnicities. Methods Athletes were screened (2012-2022) with personal/family history, physical examination, resting 12-lead ECG and followed for up to 11 years. An audit (July 2022) reviewed screening records, including demographic data, ECGs, follow-up testing and diagnoses. Abnormal/equivocal ECGs were re-reviewed using the International Criteria. Results 2,075 ECGs from 1,189 athletes (53% female, mean age 21 years; 83% European,14% Maori/Pacific Island,3% other) were included. No athletes retired for cardiac reasons; there were no cardiac deaths nor major cardiac incidents (mean follow-up from first screening, 73 months). Diagnoses included Wolff-Parkinson-White (WPW) syndrome (0.7%) and cardiomyopathies (0.3%). Overall, 3.5% of ECGs were abnormal, with ECGs of females more commonly abnormal (4.4% vs 2.5%, p=0.02) and with more abnormal T-wave inversion (TWI) (3.1% vs 0.9%, p=0.0005) compared to males. Of the abnormal TWI in females, 47% was limited to V1-V3 with no other abnormalities. Abnormality rates were similar between Maori/Pacific Island athletes and European athletes. Conclusions WPW was the most frequent diagnosis, with very little cardiomyopathy found. The proportion of abnormal ECGs was low overall, but higher in females, driven by anterior TWI V1-V3, which potentially could be a normal finding in female athletes. There was no difference in the proportion of abnormal ECGs of Maori/Pacific Island athletes compared to European athletes.
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