Document Detail


Long-term clinical significance of frequent and complex ventricular tachyarrhythmias in trained athletes.
MedLine Citation:
PMID:  12142109     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to clarify the clinical relevance of ventricular tachyarrhythmias assessed by 24-h ambulatory electrocardiograms (ECG) in a large, unique, and prospectively evaluated athletic population. BACKGROUND: For athletes with ventricular tachyarrhythmias, the risk of sudden cardiac death associated with participation in competitive sports is unresolved. METHODS; We assessed 355 competitive athletes with ventricular arrhythmias (VAs) on a 24-h ambulatory (Holter) ECG that was obtained because of either palpitations, the presence of > or = 3 premature ventricular depolarizations (PVDs) on resting 12-lead ECG, or both. RESULTS: Athletes were segregated into three groups: Group A with > or = 2,000 PVDs/24 h (n = 71); Group B with > or = 100 <2,000 PVDs/24 h (n = 153); and Group C with only <100 PVDs/24 h (n = 131). Cardiac abnormalities were detected in 26 of the 355 study subjects (7%) and were significantly more common in Group A (21/71, 30%) than in Group B (5/153, 3%) or Group C athletes (0/131, 0% p < 0.001). Only the 71 athletes in Group A were excluded from competition. During follow-up (mean, 8 years), 70 of 71 athletes in Group A and each of the 284 athletes in Groups B and C have survived without cardiovascular events. The remaining Group A athlete died suddenly of arrhythmogenic right ventricular cardiomyopathy while participating in a field hockey game against medical advice. Frequent and complex ventricular tachyarrhythmias are common in trained athletes and are usually unassociated with underlying cardiovascular abnormalities. Such VAs (when unassociated with cardiovascular abnormalities) do not convey adverse clinical significance, appear to be an expression of "athlete's heart syndrome," and probably do not per se justify a disqualification from competitive sports.
Authors:
Alessandro Biffi; Antonio Pelliccia; Luisa Verdile; Fredrick Fernando; Antonio Spataro; Stefano Caselli; Massimo Santini; Barry J Maron
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  40     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-07-26     Completed Date:  2002-08-30     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  446-52     Citation Subset:  AIM; IM    
Affiliation:
Institute of Sports Science, Department of Medicine, Italian National Olympic Committee, Rome, Italy. a.biffi@libero.it
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adrenergic beta-Antagonists / therapeutic use
Adult
Anti-Arrhythmia Agents / therapeutic use
Cardiovascular Abnormalities / diagnosis,  drug therapy,  epidemiology
Circadian Rhythm / physiology
Electrocardiography, Ambulatory
Electrophysiologic Techniques, Cardiac
Enalapril / therapeutic use
Female
Follow-Up Studies
Heart Rate / physiology
Humans
Italy / epidemiology
Male
Prevalence
Propafenone / therapeutic use
Severity of Illness Index
Sports*
Tachycardia / diagnosis*,  drug therapy,  epidemiology
Time Factors
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Anti-Arrhythmia Agents; 54063-53-5/Propafenone; 75847-73-3/Enalapril
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2002 Aug 7;40(3):453-6   [PMID:  12142110 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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