Cor Vasa 2020, 62(4):379-385 | DOI: 10.33678/cor.2020.030

(Sports and cardiac arrhythmias)

Štěpán Havránek
II. interní klinika kardiologie a angiologie, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice v Praze

Cardiac arrhythmias in competitive sports include serious ventricular tachycardias associated with structural heart diseases and arrhythmogenic syndromes, but also less risky supraventricular tachycardias. The most com- mon structural cause of sudden cardiac death is hypertrophic cardiomyopathy, followed by arrhythmogenic cardiomyopathy, dilated cardiomyopathy, long QT syndrome, early repolarization and WPW syndrome. Sudden cardiac death could occur in case of anomalous origins of coronary arteries and myocarditis. This review addresses also less risky arrhythmias which are more frequently observed in athletes, such as atrial fibrillation. Although premature ventricular beats in young athletes are usually benign, they may rarely mark underlying heart disease and risk of sudden cardiac death.

Keywords: Arrhythmia, Atrial fibrillation, Sudden cardiac death, Sports,

Received: April 8, 2020; Revised: April 21, 2020; Accepted: April 24, 2020; Published: September 16, 2020  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Havránek Š. (Sports and cardiac arrhythmias). Cor Vasa. 2020;62(4):379-385. doi: 10.33678/cor.2020.030.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Corrado D, Basso C, Rizzoli G, et al. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol 2003;42:1959-1963. Go to original source... Go to PubMed...
    2. Maron BJ, Pelliccia A. The heart of trained athletes: cardiac remodeling and the risks of sports, including sudden death. Circulation 2006;114:1633-1644. Go to original source... Go to PubMed...
    3. Marijon E, Tafflet M, Celermajer DS, et al. Sports-related sudden death in the general population. Circulation 2011;124:672-681. Go to original source... Go to PubMed...
    4. Risgaard B, Winkel BG, Jabbari R, et al. Sports-related sudden cardiac death in a competitive and a noncompetitive athlete population aged 12 to 49 years: data from an unselected nationwide study in Denmark. Heart Rhythm 2014;11:1673-1681. Go to original source... Go to PubMed...
    5. Harmon KG, Asif IM, Maleszewski JJ, et al. Incidence, Cause, and Comparative Frequency of Sudden Cardiac Death in National Collegiate Athletic Association Athletes: A Decade in Review. Circulation 2015;132:10-19. Go to original source... Go to PubMed...
    6. Maron BJ, Haas TS, Murphy CJ, et al. Incidence and causes of sudden death in U.S. college athletes. J Am Coll Cardiol 2014;63:1636-1643. Go to original source... Go to PubMed...
    7. Thelle DS, Selmer R, Gjesdal K, et al. Resting heart rate and physical activity as risk factors for lone atrial fibrillation: a prospective study of 309,540 men and women. Heart 2013;99:1755-1760. Go to original source... Go to PubMed...
    8. Abdulla J, Nielsen JR. Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis. Europace 2009;11:1156-1159. Go to original source... Go to PubMed...
    9. Mont L, Sambola A, Brugada J, et al. Long-lasting sport practice and lone atrial fibrillation. Eur Heart J 2002;23:477-482. Go to original source... Go to PubMed...
    10. Biffi A, Pelliccia A, Verdile L, et al. Long-term clinical significance of frequent and complex ventricular tachyarrhythmias in trained athletes. J Am Coll Cardiol 2002;40:446-452. Go to original source... Go to PubMed...
    11. Zipes DP, Link MS, Ackerman MJ, et al. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 9: Arrhythmias and Conduction Defects: A Scientific Statement From the American Heart Association and American College of Cardiology. Circulation 2015;132:e315-e325. Go to original source... Go to PubMed...
    12. Mozaffarian D, Furberg CD, Psaty BM, Siscovick D. Physical activity and incidence of atrial fibrillation in older adults: the cardiovascular health study. Circulation 2008;118:800-807. Go to original source... Go to PubMed...
    13. Guasch E, Benito B, Qi X, Cifelli C, et al. Atrial fibrillation promotion by endurance exercise: demonstration and mechanistic exploration in an animal model. J Am Coll Cardiol 2013;62:68-77. Go to original source... Go to PubMed...
    14. Wilhelm M, Roten L, Tanner H, et al. Atrial remodeling, autonomic tone, and lifetime training hours in nonelite athletes. Am J Cardiol 2011;108:580-585. Go to original source... Go to PubMed...
    15. Koopman P, Nuyens D, Garweg C, et al. Efficacy of radiofrequency catheter ablation in athletes with atrial fibrillation. Europace 2011;13:1386-1393. Go to original source... Go to PubMed...
    16. Calvo N, Mont L, Tamborero D, et al. Efficacy of circumferential pulmonary vein ablation of atrial fibrillation in endurance athletes. Europace 2010;12:30-36. Go to original source... Go to PubMed...
    17. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016;37:2893-2962. Go to original source... Go to PubMed...
    18. Brugada J, Katritsis DG, Arbelo E, et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia. The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J 2020;41:655-720. Go to original source... Go to PubMed...
    19. Heidbüchel H, Corrado D, Biffi A, et al, Study Group on Sports Cardiology of the European Association for Cardiovascular Prevention and Rehabilitation. Recommendations for participation in leisure-time physical activity and competitive sports of patients with arrhythmias and potentially arrhythmogenic conditions. Part II: ventricular arrhythmias, channelopathies and implantable defibrillators. Eur J Cardiovasc Prev Rehabil 2006;13:676-686. Go to original source... Go to PubMed...
    20. Verdile L, Maron BJ, Pelliccia A, et al. Clinical significance of exercise-induced ventricular tachyarrhythmias in trained athletes without cardiovascular abnormalities. Heart Rhythm 2015;12:78-85. Go to original source... Go to PubMed...
    21. Mont L, Pelliccia A, Sharma S, et al. Pre-participation cardiovascular evaluation for athletic participants to prevent sudden death: Position paper from the EHRA and the EACPR, branches of the ESC. Endorsed by APHRS, HRS, and SOLAECE. Europace 2017;19:139-163. Go to original source... Go to PubMed...
    22. Kennedy HL, Whitlock JA, Sprague MK, et al. Long-term follow-up of asymptomatic healthy subjects with frequent and complex ventricular ectopy. N Engl J Med 1985;312:193-197. Go to original source... Go to PubMed...
    23. Zorzi A, Mastella G, Cipriani A, et al. Burden of ventricular arrhythmias at 12-lead 24-hour ambulatory ECG monitoring in middle-aged endurance athletes versus sedentary controls. Eur J Prev Cardiol 2018;25:2003-2011. Go to original source... Go to PubMed...
    24. Talan DA, Bauernfeind RA, Ashley WW, et al. Twenty-four hour continuous ECG recordings in long-distance runners. Chest 1982;82:19-24. Go to original source... Go to PubMed...
    25. Ventura R, Steven D, Klemm HU, et al. Decennial follow-up in patients with recurrent tachycardia originating from the right ventricular outflow tract: electrophysiologic characteristics and response to treatment. Eur Heart J 2007;28:2338-2345. Go to original source... Go to PubMed...
    26. Niwano S, Wakisaka Y, Niwano H, et al. Prognostic significance of frequent premature ventricular contractions originating from the ventricular outflow tract in patients with normal left ventricular function. Heart 2009;95:1230-1237. Go to original source... Go to PubMed...
    27. Corrado D, Basso C, Schiavon M, Thiene G. Screening for hypertrophic cardiomyopathy in young athletes. N Engl J Med 1998;339:364-369. Go to original source... Go to PubMed...
    28. Marcus FI, McKenna WJ, Sherrill D, et al. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the Task Force Criteria. Eur Heart J 2010;31:806-814. Go to original source... Go to PubMed...
    29. Novak J, Zorzi A, Castelletti S, et al. Electrocardiographic differentiation of idiopathic right ventricular outflow tract ectopy from early arrhythmogenic right ventricular cardiomyopathy. Europace 2017;19:622-628. Go to original source... Go to PubMed...
    30. Drezner JA, Sharma S, Baggish A, et al. International criteria for electrocardiographic interpretation in athletes: Consensus statement. Br J Sports Med 2017;51:704-731. Go to original source... Go to PubMed...
    31. Corrado D, Drezner JA, D'Ascenzi F, Zorzi A. How to evaluate premature ventricular beats in the athlete: critical review and proposal of a diagnostic algorithm [published online ahead of print, 2019 Sep 3]. Br J Sports Med 2019;bjsports-2018-100529. doi: 10.1136/bjsports-2018-100529 Go to original source... Go to PubMed...
    32. Antzelevitch C, Yan GX, Ackerman MJ, et al. J-Wave syndromes expert consensus conference report: Emerging concepts and gaps in knowledge. Heart Rhythm 2016;13:e295-e324. Go to original source... Go to PubMed...
    33. Selzman KA, Gettes LS. Exercise-induced premature ventricular beats: should we do anything differently? Circulation 2004;109:2374-2375. Go to original source... Go to PubMed...
    34. Morshedi-Meibodi A, Evans JC, Levy D, et al. Clinical correlates and prognostic significance of exercise-induced ventricular premature beats in the community: the Framingham Heart Study. Circulation 2004;109:2417-2422. Go to original source... Go to PubMed...
    35. Sofi F, Capalbo A, Pucci N, et al. Cardiovascular evaluation, including resting and exercise electrocardiography, before participation in competitive sports: cross sectional study. BMJ 2008;337:a346. Go to original source... Go to PubMed...
    36. Schwartz PJ, Stramba-Badiale M, Crotti L, et al. Prevalence of the congenital long-QT syndrome. Circulation 2009;120:1761-1767. Go to original source... Go to PubMed...
    37. Ackerman MJ, Priori SG, Willems S, et al, Heart Rhythm Society and European Heart Rhythm A. HRS/EHRA expert consensus statement on the state of genetic testing for the channelopathies and cardiomyopathies: this document was developed as a partnership between the Heart Rhythm Society (HRS) and the European Heart Rhythm Association (EHRA). Europace 2011;13:1077-1109. Go to original source... Go to PubMed...
    38. Anttonen O, Junttila MJ, Rissanen H, et al. Prevalence and prognostic significance of short QT interval in a middle-aged Finnish population. Circulation 2007;116:714-720. Go to original source... Go to PubMed...
    39. Guerrier K, Kwiatkowski D, Czosek RJ, et al. Short QT Interval Prevalence and Clinical Outcomes in a Pediatric Population. Circ Arrhythm Electrophysiol 2015;8:1460-1464. Go to original source... Go to PubMed...
    40. Ackerman MJ, Zipes DP, Kovacs RJ, Maron BJ. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 10: The Cardiac Channelopathies: A Scientific Statement From the American Heart Association and American College of Cardiology. J Am Coll Cardiol 2015;66:2424-2428. Go to original source... Go to PubMed...

    This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content


    Cor et Vasa

    You are accessing a site intended for medical professionals, not the lay public. The site may also contain information that is intended only for persons authorized to prescribe and dispense medicinal products for human use.

    I therefore confirm that I am a healthcare professional under Act 40/1995 Coll. as amended by later regulations and that I have read the definition of a healthcare professional.


    No
    Yes