Initial Investigation of Athletes’ Electrocardiograms Acquired by Wearable Sensors during the Pre-exercise Phase

Sofia Romagnoli1, Agnese Sbrollini1, Massimo Colaneri2, Ilaria Marcantoni1, Micaela Morettini1, *, Gianluca Zitti3, Maurizio Brocchini3, Marco Pozzi2, Laura Burattini1
1 Department of Information Engineering, Università Politecnica delle Marche, via Brecce Bianche 12, 60131, Ancona, Italy
2 Department of Paediatric and Congenital Cardiac Surgery and Cardiology, Ospedali Riuniti, via Conca, 71, 60020, Ancona, Italy
3 Department of Construction, Civil Engineering and Architecture, Università Politecnica delle Marche, via Brecce Bianche 12, 60131, Ancona, Italy

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© 2021 Romagnoli et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy;
Tel: +390712204895; Fax: +390712204224; E-mail:



The aim of this study is to support large-scale prevention programs fighting sport-related sudden cardiac death by providing a set of electrocardiographic features representing a starting point in the development of normal reference values for the pre-exercise phase.


In people with underlying, often unknown, cardiovascular abnormalities, increased cardiovascular load during exercise can trigger sport-related sudden cardiac death. Prevention remains the only weapon to contrast sport-related sudden cardiac death. So far, no reference values have been proposed for electrocardiograms of athletes acquired with wearable sensors in the pre-exercise phase, consisting of the few minutes immediately before the beginning of the training session.


To perform an initial investigation of athletes’ electrocardiograms acquired by wearable sensors during the pre-exercise phase.


The analyzed electrocardiograms, acquired through BioHarness 3.0 by Zephyr, belong to 51 athletes (Sport Database and Cycling Database of the Cardiovascular Bioengineering Lab of the Università Politecnica delle Marche, Italy). Preliminary values consist of interquartile ranges of six electrocardiographic features which are heart rate, heart-rate variability, QRS duration, ST level, QT interval, and corrected QT interval.


For athletes 35 years old or younger, preliminary values were [72;91]bpm, [26;47]ms, [85;104]ms, [-0.08;0.08]mm, [326;364]ms and [378;422]ms, respectively. For athletes older than 35 years old, preliminary values were [71;94]bpm, [16;65]ms, [85;100]ms, [-0.11;0.07]mm, [330;368]ms and [394;414]ms, respectively.


Availability of preliminary reference values could help identify those athletes who, due to electrocardiographic features out of normal ranges, are more likely to develop cardiac complications that may lead to sport-related sudden cardiac death.

Keywords: Sport-related sudden cardiac death , Wearable sensors , Pre-exercise electrocardiography , Prevention , Training session , Athlete , Sports cardiology .