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Vigorous athletic activities are encouraged in junior school, competitive sports are part of the school curriculum during adolescence and early adulthood, and a high national emphasis is placed on elite athletes and their teams to win international championships. Endurance sports are associated with a small yet definite risk of sudden cardiac death among participants, estimated at a rate of 1–2 sudden deaths per 100 000 athletes per year in Europe,1 with an absolute number of ∼300 cardiac-related athletic deaths annually in the USA.2 During the past 25 years, cardiology societies in Europe and the USA have recognized the need for pre-participation cardiac screening in order to identify competitive athletes who are at high risk for exertion-related sudden cardiac death so that athletic-related fatalities can be minimized. In 1982, the Italian Ministry of Health established rules concerning the medical protection of athletic activity.3 In the USA the 16th Bethesda Conference was held in 1984 with a focus on cardiovascular abnormalities in the athlete and recommendations regarding eligibility for competition.4The 2005 Study Group of Sport Cardiology of the European Society of … Corresponding author. Tel: +1 585 275 5391; fax: +1 585 273 5283. E-mail address: heartajm{at}heart.rochester.edu

What duration of the QTc interval should disqualify athletes from competitive sports?