The interpretation of ECG in the young and in athletes.

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The spectrum of cardiac conditions potentially detected at the ECG in the young is broad with significant differences with the ones characterizing older patients.

1 PRACTICAL ECG COURSE The interpretation of ECG in the young and in athletes. Synopsis and aims: the practical ECG course is focused on ECG interpretation in young individuals (14-35 years) and in athletes. The spectrum of cardiac conditions potentially detected at the ECG in the young is broad with significant differences with the ones characterizing older patients. Furthermore, ECG interpretation in athletes requires careful analysis to properly distinguish physiological changes related to athletic training from findings suggestive of an underlying pathological condition. Cardiovascular-related sudden death is the leading cause of mortality in athletes during sport. Most of disorders associated with an increased risk of sudden cardiac death, such as cardiomyopathies and primary electrical diseases, are suggested by abnormal findings present on a 12-lead ECG. Therefore, ECG interpretation is an important skill for physicians involved in the cardiovascular care of athletes and of young individuals. The aim of the course is to provide a basic knowledge and ability to accurately differentiate findings suggestive of a potentially lethal cardiovascular disorder from normal variants or features of benign physiological adaptations. The course is highly interactive. At the end of the course the attendees will be able to recognize the main ECG abnormalities suggestive of a cardiac disease in young individuals and athletes. After the course, a document with MCQs will be sent via (not fail/pass process), the Course Lead will provide feedback to individuals by sending the MCQ form back with specific details about the wrong answers. Setting: the Molecular and Clinical Sciences Institute at St George s University and the charity Cardiac Risk in the Young have contributed significantly to the research on ECG interpretation in young individuals and in athletes. Professor Sanjay Sharma is the research lead of the Cardiology Clinical Academic Group and was the lead author for the international consensus document: International recommendations for electrocardiographic interpretation in athletes. Eur Heart J. 2017, J Am Coll Cardiol More information can be found here:

2 Audience: General Practitioners, Sport physicians, Consultant, Staff grade & Associate Specialist doctors, Physician assistants, Specialist Nurses. Venue: St George s University Hospital, John Parker Lecture Theatre. Programme Organizers: Dr Gherardo Finocchiaro, MD; Dr Michael Papadakis, MBBS, MD, FESC. Organizing bodies: St George s University of London and Cardiac Risk in the Young (CRY). A certificate will be issued and sent via to all the attendees. CPD (Royal College of Physicians): 4 CPD points.

3 PROGRAMME : Welcome and registration : Understanding the basic principles: P wave, QRS complex and T wave (Dr V Batchvarov) 9:30-10:00: Axis deviation, atrial enlargement, left ventricular hypertrophy 10:00-10:20: Practical and interactive reading of ECG traces 10: : Introduction on ECG interpretation in athletes: normal and abnormal findings (Professor S Sharma) Coffee break 11: : The ECG in ischemia and infarction 11:30-12:00: Practical and interactive reading of ECG traces 12: : Rhythm abnormalities in the young and in athletes: Bradyarrhythmias (Dr C Miles) 12:30-13:00: Rhythm abnormalities in the young and in athletes: Tachyarrhythmias (Dr C Miles) 13:00-13:20: Practical and interactive reading of ECG traces Lunch 14:30-14:50: The ECG in cardiomyopathies 14:50-15:10: Practical and interactive reading of ECG traces 15:10-15:30: The ECG in channelopathies 15:30-15:40: The ECG in pre-excitation and Wolff-Parkinson-White syndrome 15:40-16:10: Repolarization patterns in athletes 16:10-17:00: Interactive ECG interpretation Clinical cases End of the course

Lecturers CV: Professor Sanjay Sharma, BsC, MBChB, FRCP, MD: Professor Sharma qualified in the UK in 1989 and was appointed Consultant Cardiologist and Physician at University Hospital Lewisham and

In 2006 he took up the post of Director of Heart Muscle Diseases at Kings College London and became Professor of Cardiology at St George s University of London in 2009.

4 Lecturers CV: Professor Sanjay Sharma, BsC, MBChB, FRCP, MD: Professor Sharma qualified in the UK in 1989 and was appointed Consultant Cardiologist and Physician at University Hospital Lewisham and Honorary Senior Lecturer in cardiology at Kings College Hospital London in In 2006 he took up the post of Director of Heart Muscle Diseases at Kings College London and became Professor of Cardiology at St George s University of London in He is medical director for Virgin London Marathon, Consultant cardiologist for the CRY sports cardiology clinic at St George s Hospital, cardiologist for the English Institute of Sport, British Rugby League and the British Lawn Tennis association. Professor Sharma s interests include cardiovascular adaptation in athletes, sudden cardiac death in the young and heart muscle diseases for which he has an international reputation and has published over 150 scientific articles including original papers in highly rated peer reviewed journals. Professor Sharma was awarded the status of Fellow of the European Society of Cardiology and elected as a nucleus member of the Sport Cardiology section of the European Association of Cardiovascular Disease Prevention and Rehabilitation in the Professor Sharma leads the CRY screening programme, which is the largest of its kind in the UK. He has an active interest in medical education and is the lead tutor for the International teaching faculty for the Royal College of physicians. He has 16 years of experience in teaching for the MRCP exam and has published several educational books in medicine and cardiology including the Self-assessment colour review of cardiology and Rapid review of clinical medicine for the MRCP part 2. Dr Michael Papadakis, MBBS, MD: Dr Papadakis qualified at Imperial College School of Medicine, London in 2001 and obtained membership of the Royal College of Physicians in In 2008 he was awarded a CRY junior research fellow grant and was registered for a Medical Doctorate at King s College London and subsequently at St George s University of London. In 2011 he was awarded a clinical lectureship post and from 2016 he is a Consultant Cardiologist at St George s University. His interests include sports cardiology, conditions predisposing to sudden cardiac death in the young, prevention of young deaths and heart failure. Dr Papadakis is a member and recently elected Chair of the European Sports Cardiology nucleus. He is credited with an increasing number of publications in peer reviewed medical journals and abstracts at scientific conferences. He was awarded the Young Investigators Award for the best scientific abstract at Europrevent 2010 by the European Association for Cardiovascular Prevention and Rehabilitation.

Dr Gherardo Finocchiaro, MD: Dr Finocchiaro completed his undergraduate training and qualified from Trieste University (Italy) in 2007.

He then spent one year at Stanford University (CA, US), focusing on hypertrophic cardiomyopathy and athlete s heart, gaining a post-doctoral diploma in 2013.

He published several papers in the field of cardiomyopathies and sport cardiology. He is now clinician and researcher at St George s University Hospital, London.

5 Dr Gherardo Finocchiaro, MD: Dr Finocchiaro completed his undergraduate training and qualified from Trieste University (Italy) in He completed his fellowship in Cardiology in Trieste in April 2012, with particular interest in cardiomyopathies. He then spent one year at Stanford University (CA, US), focusing on hypertrophic cardiomyopathy and athlete s heart, gaining a post-doctoral diploma in Subsequently he worked for seven months at The Heart Hospital imaging center (London) learning cardiac MRI and gaining a level II accreditation in this field. He published several papers in the field of cardiomyopathies and sport cardiology. He is now clinician and researcher at St George s University Hospital, London. His main fields of interest are sudden cardiac death, cardiomyopathies and athletic cardiac adaptation. Dr Chris Miles BSc(Hons) MB ChB MRCP(UK) Dr Miles is a cardiology research fellow at St George s, University of London. He completed his undergraduate training at Imperial College London and the University of Bristol Medical School in After obtaining membership of the Royal College of Physicians, he commenced specialist training in cardiology in 2013, most recently working as a registrar in cardiac electrophysiology at the Royal Brompton Hospital. He is interested in the investigation of unexplained sudden death in the young, arrhythmogenic cardiomyopathy, and inherited arrhythmia syndromes. His PhD incorporates the pathological and genomic basis of these conditions. Chris is also an honorary research fellow for the UK charity Cardiac Risk in the Young (CRY) and assists with their national screening programme. He presented CRY s research as a finalist for this year s Young Investigator Award at the European Society of Cardiology Congress in Barcelona. Dr Velislav N. Batchvarov, MD, PhD: Dr Batchvarov qualified at the Medical University in Sofia, Bulgaria in He worked as a GP, cardiologist and cardiac electrophysiologist in Bulgaria before moving to the UK in For nearly 20 years he has been involved in clinical electrocardiology research at St. George s University of London. His expertise and interests include theory of electrocardiography, digital signal processing for ECG analysis, development of new computerised concepts for ECG display and analysis, ECG-based diagnosis and risk stratification in genetic arrhythmic syndromes (arrhythmogenic right ventricular cardiomyopathy, Brugada syndrome). He has vast experience in ECG teaching at all levels and many publications, book chapters and presentations at international meetings. He is currently retired and continues part-time his research at St. George s.

The interpretation of ECG in the young and in athletes.

PRACTICAL ECG COURSE The interpretation of ECG in the young and in athletes. Synopsis and aims: the practical ECG course is focused on ECG interpretation in young individuals (14-35 years) and in athletes.