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ARVC Screening Probability in Athletes (Family History + ECG) Calculator

  • Age (years)
  • Sex (1=Male, 0=Female)
  • First-degree relative with definite ARVC/ACM or a pathogenic variant (1=Yes, 0=No)
  • Family history of sudden cardiac death < 40 years (1=Yes, 0=No)
  • ECG: T-wave inversion beyond V2 (V1–V3/V4) in athlete ≥16 y (1=Yes, 0=No)
  • ECG: Inferolateral T-wave inversion in ≥2 contiguous leads (1=Yes, 0=No)
  • ECG: Prolonged terminal activation duration ≥55 ms in V1–V3 without complete RBBB (1=Yes, 0=No)
  • ECG: Epsilon wave present (1=Yes, 0=No)
  • Resting sinus rhythm heart rate (beats/min)
  • ARVC Screening Probability in Athletes: Explanation and Clinical Context
     This calculator assists sports cardiologists in assessing pre-test probability for arrhythmogenic cardiomyopathy (ARVC/ACM) in athletes using key signals: family history and characteristic ECG abnormalities. A first-degree relative with confirmed ARVC or a pathogenic variant markedly raises pre-test suspicion. Similarly, young-age sudden cardiac death in the family warrants caution. On ECG, T-wave inversion beyond V2 in athletes aged ≥16 years, inferolateral T-wave inversion, a terminal activation duration ≥55 ms in V1–V3, or epsilon waves are red flags for pathological remodeling. Athletes categorized “High” should undergo cardiac imaging (echo, CMR), Holter or exercise ECG, and potentially genetic testing before sports clearance. This tool is not for diagnostic use but to prioritize further evaluation.

    References:
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    Muller SA, et al. J Am Coll Cardiol. 2023;82:214–225.
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    Lampert R, et al. Heart Rhythm. 2024. (HRS consensus on arrhythmias in athletes)