Electrocardiographic profile of South African Premier League football players: A descriptive cross-sectional study.

BACKGROUND

High-intensity soccer participation induces benign structural and functional cardiac adaptations collectively known as the athlete's heart. However, sudden cardiac death (SCD) remains an important concern, emphasising the need for appropriate cardiovascular screening among competitive soccer players, particularly in settings where routine pre-participation cardiac screening protocols are not consistently implemented across all levels of competition nationally.

OBJECTIVES

To assess resting sport electrocardiogram (ECG) profiles of South African professional soccer players using international consensus standards for ECG interpretation in athletes.

METHODS

This cross-sectional study included 105 male South African Premier Soccer League players aged 17-39 years. Resting ECGs were recorded using the Custo-med Diagnostic Sport ECG device and interpreted according to international consensus criteria for athlete ECG interpretation.

RESULTS

Age and weight were not significantly associated with cardiac risk level (p=0.867 and p=0.400, respectively). Heart rate was significantly associated with risk level (p=0.002), with players presenting heart rates ≥76 bpm showing a higher proportion of moderate risk (63.6%). No significant associations were observed between age, weight, or heart rate and T-wave inversion. Heart rate was significantly associated with right atrial enlargement (p=0.037), particularly among players with heart rates ≥76 bpm, whereas age and weight showed no significant associations.

CONCLUSION

Resting ECG screening may assist with the early identification of potentially important cardiac abnormalities in South African soccer players. Annual ECG screening should be considered for both development and senior squads, together with appropriate clinical follow-up and emergency preparedness. These findings support broader cardiovascular screening strategies aligned with international football medicine recommendations.