Low QRS voltages in young healthy individuals and athletes
Research type
Research Study
Full title
The prevalence and significance of low QRS voltages in young healthy individuals and athletes
IRAS ID
283055
Contact name
Sabiha/SG Gati
Contact email
Sponsor organisation
Imperial College London and Imperial College Healthcare NHS Trust
Duration of Study in the UK
5 years, 0 months, 0 days
Research summary
The electrocardiogram measures the electrical activity of the heart. Each heartbeat consists of a QRS complex which denotes contraction of the ventricles (lower chambers of the heart). Small QRS complexes are defined as QRS voltages <0.5 mV. There is emerging evidence in the literature that small QRS complexes (electrical spikes relating to the heartbeat) on the electrocardiogram (tracing of electrical impulses from the heart) may be associated with scarring in the heart muscle and result in serious life-threatening heart rhythms or even sudden death. The prevalence of low QRS voltages in the general population is between 1-2% but this includes people with airway disease, underactive thyroid, obesity and heart muscle conditions. The prevalence of low QRS complexes in an apparently healthy young population aged of 17-35 years old is unknown. The death of an athlete from an unsuspected heart condition has a significant impact on society. One study revealed 4% of Italian athletes had small QRS complexes. Subsequent ultrasound of the heart did not reveal evidence of structural disease. Unfortunately, cardiac ultrasound is unable to detect scarring in the heart, therefore the precise significance of small QRS complexes on the ECG remains unclear in this population. Sports doctors and nurses rely on the international recommendations for ECG interpretation when assessing young athletes, however, low QRS complexes do not features in the abnormalities that warrant further evaluation. It is possible that several young individuals with serious cardiac abnormalities may be identified if the significance of small QRS complexes is elucidated. The purpose of this project is to examine electrical traces of young individuals. We will also examine traces from athletes from a variety of sports. Individuals with small QRS complexes will be offered a cardiovascular magnetic resonance scan and/or genetic evaluation to determine significance of small QRS complexes.
REC name
London - West London & GTAC Research Ethics Committee
REC reference
23/PR/0361
Date of REC Opinion
30 Jun 2023
REC opinion
Further Information Favourable Opinion