PRACTICAL ECG COURSE - St George's, University of London
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PRACTICAL ECG COURSE
How to interpret the ECG of athletes and young adults – the digital
experience
Synopsis and aims: the practical ECG course is focused on the ECG interpretation in young individuals
(14-35 years) and in athletes. The spectrum of cardiac conditions potentially detected by the ECG in
the young is broad with significant differences with the ones affecting older patients. Furthermore,
ECG interpretation in athletes requires careful analysis to 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. The 12-lead ECG in
increasingly used as a screening tool as it may raise suspicion of most of the disorders associated with
an increased risk of sudden cardiac death, such as cardiomyopathies and primary electrical diseases.
Therefore, ECG interpretation is an important skill for anyone involved in the cardiovascular care of
young and athletic individuals.
The aim of the course is to equip participants with knowledge regarding the interpretation of the ECG
of a young or athletic individual, so they can accurately differentiate findings suggestive of a
potentially lethal cardiovascular disorder from normal variants or features of benign physiological
adaptation.
The course is highly interactive through Q&A sessions and Multiple choice questions supported case-
based learning.
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 was the lead author for the international
consensus document, which now forms the gold standard for the ECG interpretation in athletes.
International recommendations for electrocardiographic interpretation in athletes. Eur Heart J. 2017,
J Am Coll Cardiol. 2017. More information can be found here:
http://www.c-r-y.org.uk/research/crys-contribution-to-research/
https://www.ncbi.nlm.nih.gov/pubmed/?term=sharma+papadakis
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COURSE DETAILS
Audience: The course is aimed to anyone who has an interest in ECG interpretation. Cardiologists,
general practitioners, sport physicians, junior doctors, physician assistants, nurses, physiologists.
Venue: Digital course
Course Directors: Dr Gherardo Finocchiaro, Dr Michael Papadakis
Course Coordinator: Ms Nikki George
IT Coordinator: Mr Luke Woodham
Organizing bodies: St George’s University of London.
The course is fully supported by Cardiac Risk in the Young (CRY).
Costs: £90
£60 for students (the student will have to provide a letter from his/her institution)
£60 for members from supported organisations. Please see booking page for full list.
The maximum number of attendees is 200.
The course is hosted on a Microsoft Teams digital platform – the attendees will be able to interact
with the speakers and ask questions, raise comments and respond to MCQs.
The course comprises of 3 sessions (2 hours each) offered on 3 different days. The first part (80
minutes) of each session will be lecture based, the second part (40 minutes) will be Q&A sessions
and case-based learning. The attendees are encouraged to participate to the live lectures, but
they would be able to access the recordings for up to 4 weeks from the end of the live course, in
case they are not able to attend. A certificate of attendance from St George’s University will be
issued at the end of the course.
CPD (6 points) will be sought from Royal College of Physicians.
Learning Objectives
After this course, participants will be able to:
• Interpret a young individual’s and an athlete’s ECG.
• Differentiate normal ECG variants and ECG features consistent with athletic adaptation from
those suggestive of pathology.
• Determine necessary investigations in young individuals and athletes with ECG changes
suggestive of pathology.
Attendees will be asked to complete online assignment (MCQs) between sessions and feedback
will be provided. This is for the participants’ own learning and not a fail/pass process.
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PROGRAMME
Monday 21st of September – 20 ECGs with single best answer questions as a pre-course
assessment.
Monday 28th of September (17.00 – 19.00 Greenwich time)
Focus on the basics of the athlete’s ECG
Moderator: Dr A Malhotra
17.00-17.20 Basic principles of ECG interpretation – The normal ECG
Dr G Finocchiaro
17.20-17.40 What is a normal ECG for an athlete?
Dr M Papadakis
17:40-18:00 Borderline ECG changes in athletes; What do they mean?
Dr S Gati
18.00-18.20 Abnormal ECG patterns in athletes; The things not to miss!
Prof S Sharma
18:20-18:40 Question & Answer session with our experts
Dr G Finocchiaro, Dr S Gati, Dr M Papadakis, Prof S Sharma
18.40-19.00 Interactive cases (MCQs)
Dr G Finocchiaro, Dr S Gati, Dr M Papadakis, Prof S Sharma
After the end of the first webinar the participants will have the opportunity to review 20 ECGs
with single best answer questions and discussion of the responses for self-assessment.
Monday 5th of October (17.00 – 19.00 Greenwich time)
Focus on rhythm abnormalities in the young and in athletes
Moderator: Dr G Finocchiaro
17:00-17:20 The slow heart rate; When to worry
Dr M Papadakis
17:20-17:40 The fast heart rate; Recognising patterns
Dr B Ensam
17:40-18:00 Premature ventricular beats in athletes
Prof S Sharma
18:00-18:20 The ECG in channelopathies
Prof ER Behr
18:20-18:40 Question & Answer session with our experts
Prof ER Behr, Dr B Ensam, Dr M Papadakis, Prof S Sharma
18:40-19:00 Interactive cases (MCQs)
Prof ER Behr, Dr B Ensam, Dr M Papadakis, Prof S Sharma
After the end of the second webinar the participants will have the opportunity to review 20
ECGs with single best answer questions and discussion of the responses for self-assessment.
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Monday 12th of October (17.00 – 19.00 Greenwich time)
The grand finale!
Moderator: Dr M Papadakis
17:00-17.20 Repolarization patterns in athletes; Influence of demographics & sport
Dr A Malhotra
17:20-17:40 The ECG in cardiomyopathies
Dr G Finocchiaro
17:40-18:00 The ECG in ischemia and myocarditis
Prof S Sharma
18:00-18:20 Question & Answer session with our expert
Dr G Finocchiaro, Dr Aneil Malhotra, Prof S Sharma
18:20-19:00 Interactive cases extravaganza (MCQs)
Dr G Finocchiaro, Dr Aneil Malhotra, Prof S Sharma
20 ECGs with single best answer questions as a post-course assessment (same ECGs as pre-
course assessment).
End of the course
All course material, including recorded lectures, will remain available to participants until the 9th of
November 2020.
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Lecturers CV:
Dr Michael Papadakis, MBBS, MD, MRCP, FESC
Dr Papadakis is a Reader (Assoc Professor) in Cardiology at St George’s, University of
London and an Honorary Consultant Cardiologists at St George’s University
Hospitals. Dr Papadakis qualified at Imperial College School of Medicine in London in
2001 and gained membership of the Royal College of Physicians in 2007. In 2014 he
was awarded a Medical Doctora at King’s College London. He is the chair of the
section of Sports Cardiology and Exercise of the European Association of Preventive
Cardiology (EAPC). His interests include sports cardiology, inherited cardiac
diseases, cardiovascular disease prevention including prevention of sudden cardiac
death in young and athletic individuals, heart failure and cardiac imaging. Dr
Papadakis is currently credited with more than 80 publications in peer reviewed
medical journals and numerous presentations in national and international
conferences. He has contributed to a number of projects as an expert, including the
creation of the Sports Cardiology core curriculum, the creation of the international
ECG criteria for an athlete’s evaluation and exercise recommendations in individuals
with heart disease. He has advanced education in the field of Sports Cardiology by building educational
material for the European Society of Cardiology and launching a novel MSc degree in Sports Cardiology, the
first postgraduate qualification of its kind.
Dr Gherardo Finocchiaro, MD, PhD, FESC
Dr Finocchiaro completed his undergraduate training and qualified from Trieste
University (Italy) in 2007. 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 his research on hypertrophic
cardiomyopathy and athlete’s heart, gaining a post-doctoral diploma in 2013.
Subsequently he worked at The Heart Hospital imaging center (London) learning
about cardiac MRI and gaining a level III accreditation in this field. He spent 4 years
at St George's University Hospital in London, under the supervision of Professor
Sharma, completing a PhD in 2019 with > 60 papers published on major
international journals in the field of sudden death in the young, cardiomyopathies
and sports cardiology. He is now Consultant and researcher at Guy's and St
Thomas Hospital and King's College London. His main fields of interest are sudden
cardiac death, cardiomyopathies and athletic cardiac adaptation.
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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 2001. 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. 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 2008. 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.
Professor Elijah R Behr MA Cantab, MBBS, MD, FRCP, FESC
Professor Behr is a recognised national and international expert in the field of
arrhythmias. He is Professor in Cardiovascular Medicine and Honorary
Consultant Cardiologist specialising in Electrophysiology at St George's,
University of London and St George's Hospital, London. He runs an Arrhythmia
service and co-leads the Inherited Cardiac Conditions clinic at St George's,
coordinating a multi-disciplinary team that provides a single one-stop service
to families including children. Professor Behr is past president of the
Association for Inherited Cardiac Conditions (AICC). He has established the
European Cardiac Arrhythmia Genetics (ECGen) Group of the EHRA and is the
first chairperson. He co-leads the arrhythmia syndrome sub-domain of the UK
100,000 Genomes Project Cardiovascular Genome England Clinical Interpretation Partnership. He is an
editorial board member of the Heart Rhythm journal and co-wrote international guidelines for diagnosis &
management of arrhythmia syndromes. He is Health Care Partner lead for the European Rare Disease
Reference Network GUARD-HEART and co-chairs the South London ICC (SLICC) network. Professor Behr’s
research interests include prediction of sudden death risk; drug-induced arrhythmia; families with the
Sudden Arrhythmic Death Syndrome (SADS) and Sudden Infant Death Syndrome (SIDS); ion channel diseases
including long QT and Brugada syndromes; and arrhythmogenic cardiomyopathy.
6Dr Sabiha Gati BSc, MBBS, MRCP, PhD, FESC
Sabiha initiated her career with a BSc degree in Physiology/Pharmacology at
University College London for which she was awarded a 1st Class
Honours. Following on, she completed her undergraduate medical training
at Guy’s, King’s & St. Thomas’ School of Medicine, London in 2004. After
completing her junior medical training as a doctor, she obtained membership
of the Royal College of Physicians in 2007. Subsequently, Sabiha was
appointed as a Specialist training registrar in cardiology and has completed 5
years of specialist training in London with sub-specialisation in advanced
echocardiography and cardiovascular magnetic resonance (CMR). She
obtained her Certificate of specialist training in Cardiology and General
(internal) Medicine in October 2016. Sabiha has level III accreditation in CMR
(EACVI) and is accredited in echocardiography by the British Society of
Echocardiography. She completed 3 years of her PhD research training
involving echocardiography and inherited cardiac diseases. Sabiha won
several awards and prizes for her research including the Hinchliffe Award for
the most successful CRY research fellow of the year. After completing her
PhD and specialist training, Sabiha embarked on a 12-month fellowship training in cardiac MRI at Royal
Brompton Hospital with a further 6-month experience as a CMR consultant at the institution. Sabiha worked
for two years as a Consultant Cardiologist at Lister Hospital, Hertfordshire and continued her CMR work at the
Brompton Hospital. Sabiha currently works full-time at the Royal Brompton Hospital in the Inherited Cardiac
conditions service and CMR imaging unit and is the lead for the Sports Cardiology service. Sabiha is also the
Deputy Editor for education and training for the EHJ-Case Reports and the Section Editor for the EAPC sports
cardiology quizzes. Sabiha continues her work as a CRY Cardiologist and is an active member of the CRY pre-
participation screening programme in athletes for the English Institute of Sport, Lawn Tennis Association,
Premier Football League and Rugby Union. She has successfully published her work on mechanisms in Left
ventricular Hypertrabeculation in Circulation journal. Her other peer-reviewed publications include work
relating to Left ventricular hypertrabeculation in Athletes published in Heart, and ECG guidelines in athletes,
published in European Heart Journal and recently aortic dimension in athletes in Heart. She also co-authored
a land-mark study on cardiac screening in adolescent athletes in the NEJM. More recently, Sabiha has co-
authored EAPC recommendations for athletes with Valvular heart disease and she has also been a member of
the expert task force for the ESC guidelines in sports cardiology and exercise in individuals with cardiovascular
diseases. She has presented in several plenary sessions at the ESC, EuroEcho, EuroPrevent and ACC.
Dr. Aneil Malhotra PhD, MB, BChir, MA (Cantab), MRCP (UK), MSc
Aneil is a Consultant Cardiologist in Manchester. He graduated from
the University of Cambridge (Emmanuel College) in 2006 and spent
his Foundation years working in Cambridge and Papworth before
moving to Oxford to continue his specialist training in cardiology.
Along the way, he completed a Masters in Medical Leadership at
the Royal College of Physicians (2013). He completed his doctorate
in inherited he art diseases and sports cardiology at St. George’s
University of London where he was subsequently appointed NIHR
Clinical Lecturer. Aneil’s research areas include investigating the
electrical, structural and functional features of the adolescent
athlete’s heart with data derived from analysing the Football Association’s cardiac screening programme, the
7largest of its kind for elite junior athletes in Europe. His work has achieved Young Investigator Award and
best abstract prizes at international conferences including ESC 2017, ACC 2016 and EACP 2015. He has a
keen interest in medical education and has been an examiner and tutor for the Royal College of Physicians
for the MRCP Part 2 (2014-2017) as well as a Module lead and Admissions Tutor for the MSc in Sports
Cardiology at St. George’s University of London. Aneil is the European Association of Preventative Cardiology
young ambassador for the UK. He has over 60 peer-reviewed publications and has co-authored and
contributed to books in cardiology and stroke medicine. His ongoing research interests include sudden
cardiac death in footballers and ethnic differences between black, white and mixed-race athletes’ hearts.
Dr Bode Ensam MBChb, BSc, MRCP
Dr Ensam qualified in 2007 and gained membership to the Royal College of
Physicians in 2010. He have trained in cardiology at various sites across the
country including Dorset, Hampshire, London and the West Midlands. He is
currently a fellow in cardiac electrophysiology at The University Hospital
Birmingham and undertake curative electrophysiological procedure’s using
catheter ablation. He also undertake cardiac device implantation. Dr Ensam is
interested in the management of patients with both common and rare heart
rhythm disorders and both clinical and research genomics. He undertook a
four-year period of research with Prof. Elijah Behr at St George’s University.
His areas of interest involve the genetic causes of sudden cardiac death and
conditions such as Brugada Syndrome, Long QT syndrome, Catecholaminergic
Polymorphic Ventricular Tachycardia and Idiopathic Ventricular Fibrillation. Dr Ensam’s research is funded by
Cardiac Risk in the Young, McColls retail group and The British Heart Foundation.
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