75A retrospective analysis of 12 lead ECGs from young patients referred to a syncope service using the "Seattle Criteria".

INTRODUCTION: In 2012, the ESC, AMSSM, EACPR, F-MARC and PACES released a consensus statement for ECG screening of young athletes. It's principal aim was to identify features suggestive of channelopathy or cardiomyopathy rather than those associated with athletic training, and was dubbed "the Seattle Criteria". Bradford Royal Infirmary runs a nurse-led syncope service with approximately 100 patients under the age of 35 referred for assessment per annum. We sought to assess the presence of "adverse" ECG features, if any, in patients referred.

METHOD: All patients under 35 years of age referred to the syncope service at Bradford Royal Infirmary between January 2012 and April 2014 were included. ECGs recorded on the online hospital database were reviewed in all cases. All the data was anonymised and retrospectively reviewed independently by two separate assessors (JF, PP) in accordance with the "Seattle criteria", and abnormalities were documented. Any ECGs with adverse features or finding of an ambiguous nature were reveiwed by CAM.

RESULTS: In total, 271 patients were referred between January 2012 and April 2014. Age ranged between 15-35 years of age (mean 25.0 years). 60.5% (155/271) were female. Patients had a median of 4 ECGs performed (range 1-12). 17/271 (6.6%) had ECGs deemed abnormal by the " Seattle Criteria". 1 patient had pathological Q waves. 3 patients had prolonged QT intervals (measured using Bazett's formula). 4 patients had T wave inversion in leads V1-V6. 1 patient had anterior ST depression. 1 patient had bifasicular block and 2 had left anterior hemiblock. 2 patients had atrial tachyarrhythmias; 1 with atrial fibrillation and the other with features suggestive of atrioventricular nodal reentrant tachycardia. 3 patients had >2 ventricular ectopics on their 10 second ECG recording, all with unifocal ectopics (1 had right bundle branch pattern the other 2 had left bundle branch type pattern).

CONCLUSION: The use of the "Seattle Criteria" for ECG screening of young patients referred to the syncope service highlighted a significant proportion with abnormal features suggestive of primary electrical disorders or potential cardiomyopathy. These screening guidelines are a simple and standardised method for ECG interpretation; they help to heighten clinical suspicion and scrutiny in certain patients at risk of sudden cardiac death. We advocate the use of this criteria in such clinical cohorts to greater stratify risk of sudden cardiac death.