Electrocardiographic alterations in football referees after a day at rest. A descriptive study
DOI:
https://doi.org/10.71068/00m0w236Keywords:
electrocardiography, referee, heart, football, sports medicine [DeCS]Abstract
Professional football referees often exhibit electrocardiographic changes considered normal within the context of an athlete’s heart. Electrocardiography (ECG), being an accessible and straightforward method, allows for the early detection of other conditions that may require more thorough evaluation. The aim of this study was to describe electrocardiographic alterations in a group of professional football referees after a day of rest in Quito. A descriptive and retrospective study was conducted with a population of 116 referees, of whom 88 (75.8%) participated. A 12-lead ECG was performed following a day of inactivity, with informed consent obtained. Of the participants, 84.1% (n=74) were male, with a mean age of 23.5 years. Findings included normal ECG (27.3%), ST-T segment alterations (54.5%), QRS complex changes (40.9%), sinus bradycardia (19.3%), right bundle branch block (10.2%), S1S2S3 electrical pattern (6.8%), second- and third-degree atrioventricular block (4.5%), and atrial fibrillation or flutter (4.5%). Inferior myocardial injury was suggested in 9.1% (n=8) and anteroseptal injury in 34.1% (n=30). The ECGs taken after a day of rest revealed changes in repolarisation, rhythm, and cardiac morphology, most of which were compatible with normal physiological adaptations; however, some abnormalities potentially indicative of previous myocardial ischaemia were also identified, highlighting the need for more comprehensive cardiovascular follow-up in these referees.
References
Birk, A., Reichert, T., Schons, P., Costa, R., Delevatti, R., Denadai, B., et al. (2023). External loads of elite soccer referees: A systematic review with meta-analysis. Research in Sports Medicine, 31(4), 342–356. https://doi.org/10.1080/15438627.2021.1988948
Martinho, D., Field, A., Rebelo, A., Gouveia, É., & Sarmento, H. (2023). A systematic review of the physical, physiological, nutritional and anthropometric profiles of soccer referees. Sports Medicine - Open, 9(1), 72–76. https://doi.org/10.1186/s40798-023-00610-7
Małgorzata, J., Jurczac, A., Wieder, H., Jarosz, A., & Marchielewicz, M. (2022). Comparison of the risk of cardiovascular diseases, stroke, and diabetes among the selected group of football referees and the group of general population men from Northern Poland – A pilot study. European Review for Medical and Pharmacological Sciences, 26(1), 3151–3160. https://www.europeanreview.org/wp/wp-content/uploads/3151-3160.pdf
Kiss, O., Babity, M., Kovacs, A., Skopal, J., Vago, H., Lakatos, B. K., et al. (2021). Significance of extended sports cardiology screening of elite handball referees. PLoS ONE, 16(4), e0249923. https://doi.org/10.1371/journal.pone.0249923
McDonald, H., Colster, E., Mulholland, A., Holmes, C., Bentley, B., Robinson, J., et al. (2023). Physical demands and physiological strain of American football referees while officiating. The Physician and Sportsmedicine, 51(4), 351–360. https://doi.org/10.1080/00913847.2022.2090869
Martínez, G., Martín, M., García, J., Felipe, J., Moreno, V., Paredes, V., et al. (2023). Physical demands on professional Spanish football referees during matches. Science and Medicine in Football, 7(2), 139–145. https://doi.org/10.1080/24733938.2022.2064539
Urhausen, A., Vivas, J., Lambert, C., & Weiler, B. (2022). Cardiovascular stress in football referees. Deutsche Zeitschrift für Sportmedizin, 73(1), 30–35. https://www.germanjournalsportsmedicine.com/archiv/archive-2022/issue-1/cardiovascular-stress-in-football-referees/
Rakhmanov, Y., Toktarbay, B., Khamitova, Z., & Salustri, A. (2024). ECG in athletes. En A. Salustri (Ed.), Technology in Sports - Recent Advances, New Perspectives and Application (pp. 129–148). IntechOpen. https://www.intechopen.com/chapters/1168861
Elsevier Connect. (2023). Electrocardiograma de 12 derivaciones: derivaciones y ejes. https://www.elsevier.com/es-es/connect/electrocardiograma-de-12-derivaciones-derivaciones-y-ejes
Sharma, S., Drezner, J. A., Baggish, A., Papadakis, M., Wilson, M. G., Prutkin, J. M., et al. (2018). International recommendations for electrocardiographic interpretation in athletes. European Heart Journal, 39(16), 1466–1480. https://doi.org/10.1093/eurheartj/ehw631
Lima, L., Salum, E., Borba, E., & Vale, R. (2019). Heart rate and the distance performed by the soccer referees during matches: A systematic review. Archivos de Medicina del Deporte, 36(1), 36–42. https://www.researchgate.net/publication/331984484
Stojanovic, S., İlbak, İ., Lilić, A., & Kurhan, S. (2024). Heart rate of soccer referees during matches: A systematic review. Turkish Journal of Kinesiology, 10(2), 131–137. http://dergipark.org.tr/en/doi/10.31459/turkjkin.1462145
Yousefian, F., Zafar, A., Peres, P., Brito, J., Travassos, B., & Figueiredo, P. (2023). Intensity demands and peak performance of elite soccer referees during match play. Journal of Science and Medicine in Sport, 26(1), 58–62. https://doi.org/10.1016/j.jsams.2022.09.009
Gomes, R., Mendes, R., Ferreira, A., Mendes, R., Dias, G., & Martins, F. (2024). Physical and physiological demands of amateur Portuguese field and assistant football referees. Sports, 12(5), 133–139. https://doi.org/10.3390/sports12050133
Tiama, A., Yaméogo, A., Gouthon, P., & Kuelagn, X. (2022). Resting electrocardiographic characteristics in male elite and subelite football referees from Burkina Faso. African Journal for Physical Activity and Health Sciences, 28(2), 15–21. https://journals.co.za/doi/epdf/10.37597/ajphes.2022.28.2.6
Galanti, G., Pizzi, A., Lucarelli, M., Stefani, L., Gianassi, M., Di Tante, V., et al. (2008). The cardiovascular profile of soccer referees: An echocardiographic study. Cardiovascular Ultrasound, 6(1), 8–15. https://doi.org/10.1186/1476-7120-6-8
La Gerche, A., Wasfy, M., Brosnan, M., Claessen, G., Fatkin, D., Heidbuchel, H., et al. (2022). The athlete’s heart—Challenges and controversies. Journal of the American College of Cardiology, 80(14), 1346–1362. https://doi.org/10.1016/j.jacc.2022.08.750
Palermi, S., Cavarretta, E., D’Ascenzi, F., Castelletti, S., Ricci, F., Vecchiato, M., et al. (2023). Athlete’s heart: A cardiovascular step-by-step multimodality approach. Reviews in Cardiovascular Medicine, 24(5), 151. https://doi.org/10.31083/j.rcm2405151
Hamid, M., Shariff, S., Salim, A., Hussein, K., Jaafar, Z., & Abdul Karim, S. (2021). Electrocardiographic (ECG) characteristics among Malaysian athletes. Sains Malaysiana, 50(11), 3355–3363. http://www.ukm.my/jsm/pdf_files/SM-PDF-50-11-2021/19.pdf
Egger, F., Scharhag, J., Kästner, A., Dvořák, J., Böhm, P., & Meyer, T. (2022). FIFA Sudden Death Registry (FIFA-SDR): A prospective, observational study of sudden death in worldwide football from 2014 to 2018. British Journal of Sports Medicine, 56(2), 80–87. https://doi.org/10.1136/bjsports-2020-102368
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Juan Fernando Hidrobo Coello (Autor/a)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Los artículos publicados en la revista se distribuyen bajo la licencia Creative Commons Atribución 4.0 Internacional (CC BY 4.0). Esta licencia permite a terceros descargar, copiar, distribuir, adaptar y reutilizar una obra, incluso con fines comerciales, siempre que se otorgue el crédito adecuado al autor original.
