Prevalence and significance of notched T-waves in elite professional cyclists



To our knowledge the 1st study reporting a high prevalence of NTWs in athletes

NTWs in athletes associated with prolonged repolarization.

NTWs in athletes associated with an enlarged left ventricle.

No evidence of an association between NTWs and unfavourable outcomes




To identify the frequency and significance of notched T-waves (NTW) in elite endurance athletes.


Professional cyclists were followed for 4 years with a clinical, electrocardiographic and echocardiographic assessment. Electrocardiograms were classified according to the presence or absence of NTWs; clinical and echocardiographic correlates were assessed.


42 Caucasian male cyclists were included. NTW were detected in 8 (19%) cyclists who showed significantly longer QT (461 ± 15 vs 422 ± 33 ms, p < 0.01) and QTc intervals (434 ± 19 vs 383 ± 21 ms, p < 0.01), a larger left ventricular end-diastolic volume (163 ± 27 vs 137 ± 23 mL, p = 0.014), end-diastolic volume index (84 ± 13 vs 73 ± 11 mL, p = 0.037) and end-diastolic apex-to-base length (9.9 ± 0.7 vs 9.3 ± 0.5 mm. p = 0.035). There were no detected arrhythmic events, and echocardiography did not reveal any abnormalities.


This is to our knowledge the first study reporting a high prevalence of NTW in athletes. In our small cohort of cyclists NTW were associated with QT interval prolongation and left ventricular changes. This may be indicative of underlying inhomogeneity of repolarisation. Expanding on this research could reveal a role for NTW in identifying ventricular morphological changes.


  • Sports cardiology
  • Athlete's ECG
  • Notched T waves 

Autor / Fonte:Jose David Arroja, Georgios Giannakopoulos, Anna Louise Beale, Dipen Shah, Philippe Meyer International Journal of Cardiology 2018 April 22