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Noninvasive cardiac screening in young athletes with ventricular arrhythmias.

Steriotis AK, Nava A, Rigato I, Mazzotti E, Daliento L, Thiene G, Basso C, Corrado D, Bauce B - Am. J. Cardiol. (2012)

Bottom Line: Results of ECG were normal in most athletes (85%).Overall, 30% of athletes were judged to have potentially dangerous VAs.In conclusion, cardiac screening with noninvasive examinations remains a fundamental tool for the identification of a possible pathologic substrate and for the characterization of electrical instability.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. steriotis@hotmail.com

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Related in: MedlinePlus

Flow diagram demonstrating the workout and results of cardiologic screening. In 43 athletes (30%), VAs were judged to be potentially dangerous on the basis of the arrhythmic pattern (complex idiopathic VAs or VAs triggered by mild abnormalities) and/or the presence of organic heart disease or nonspecific abnormalities on cardiac magnetic resonance imaging (CMR) that diagnosis was not definite. The box labeled “definitive diagnosis of organic heart disease” included 4 congenital diseases/abnormalities, 1 arrhythmogenic RV cardiomyopathy, and 1 pericardial effusion. The box labeled “mild abnormalities” mostly included mitral valve prolapse and also mild mitral regurgitation, atrial septal aneurysm, RV apical hypokinesia, 1 case of mild aortic regurgitation, and 1 case of moderate LV enlargement. The box labeled “idiopathic ventricular arrhythmias” included VAs in the absence of structural disease or VAs not related to the type of abnormality. VPC = premature ventricular complex.
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fig2: Flow diagram demonstrating the workout and results of cardiologic screening. In 43 athletes (30%), VAs were judged to be potentially dangerous on the basis of the arrhythmic pattern (complex idiopathic VAs or VAs triggered by mild abnormalities) and/or the presence of organic heart disease or nonspecific abnormalities on cardiac magnetic resonance imaging (CMR) that diagnosis was not definite. The box labeled “definitive diagnosis of organic heart disease” included 4 congenital diseases/abnormalities, 1 arrhythmogenic RV cardiomyopathy, and 1 pericardial effusion. The box labeled “mild abnormalities” mostly included mitral valve prolapse and also mild mitral regurgitation, atrial septal aneurysm, RV apical hypokinesia, 1 case of mild aortic regurgitation, and 1 case of moderate LV enlargement. The box labeled “idiopathic ventricular arrhythmias” included VAs in the absence of structural disease or VAs not related to the type of abnormality. VPC = premature ventricular complex.

Mentions: After clinical evaluation, 30% of athletes were judged to have potentially dangerous VAs on the basis of the presence of a morphologic substrate and/or the characteristics of VA pattern according to the recommendations for competitive sports, tailored to each athlete and type of sport10–12 (Figure 2). Borderline cases belonging to the “gray zone” of diagnosis between athlete's heart and arrhythmogenic RV cardiomyopathy were also judged potentially dangerous. Among these athletes, 10% (n = 14) were treated with antiarrhythmic drugs, in 1.4% (n = 2) ablation was indicated, and in 1 athlete surgical repair of the congenital defect was indicated. In the rest of the athletes, competitive sports were not recommended, and detraining was proposed (n = 26). Follow-up was feasible in 93 athletes (mean 28 months). A decrease of >70% in the number of PVCs compared to the first Holter monitoring was observed in 34 (37%), while in 31 (33%), VAs did not show significant changes, and in 28 (30%), PVCs increased. During follow-up, no athlete presented with a major cardiac event.


Noninvasive cardiac screening in young athletes with ventricular arrhythmias.

Steriotis AK, Nava A, Rigato I, Mazzotti E, Daliento L, Thiene G, Basso C, Corrado D, Bauce B - Am. J. Cardiol. (2012)

Flow diagram demonstrating the workout and results of cardiologic screening. In 43 athletes (30%), VAs were judged to be potentially dangerous on the basis of the arrhythmic pattern (complex idiopathic VAs or VAs triggered by mild abnormalities) and/or the presence of organic heart disease or nonspecific abnormalities on cardiac magnetic resonance imaging (CMR) that diagnosis was not definite. The box labeled “definitive diagnosis of organic heart disease” included 4 congenital diseases/abnormalities, 1 arrhythmogenic RV cardiomyopathy, and 1 pericardial effusion. The box labeled “mild abnormalities” mostly included mitral valve prolapse and also mild mitral regurgitation, atrial septal aneurysm, RV apical hypokinesia, 1 case of mild aortic regurgitation, and 1 case of moderate LV enlargement. The box labeled “idiopathic ventricular arrhythmias” included VAs in the absence of structural disease or VAs not related to the type of abnormality. VPC = premature ventricular complex.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3569714&req=5

fig2: Flow diagram demonstrating the workout and results of cardiologic screening. In 43 athletes (30%), VAs were judged to be potentially dangerous on the basis of the arrhythmic pattern (complex idiopathic VAs or VAs triggered by mild abnormalities) and/or the presence of organic heart disease or nonspecific abnormalities on cardiac magnetic resonance imaging (CMR) that diagnosis was not definite. The box labeled “definitive diagnosis of organic heart disease” included 4 congenital diseases/abnormalities, 1 arrhythmogenic RV cardiomyopathy, and 1 pericardial effusion. The box labeled “mild abnormalities” mostly included mitral valve prolapse and also mild mitral regurgitation, atrial septal aneurysm, RV apical hypokinesia, 1 case of mild aortic regurgitation, and 1 case of moderate LV enlargement. The box labeled “idiopathic ventricular arrhythmias” included VAs in the absence of structural disease or VAs not related to the type of abnormality. VPC = premature ventricular complex.
Mentions: After clinical evaluation, 30% of athletes were judged to have potentially dangerous VAs on the basis of the presence of a morphologic substrate and/or the characteristics of VA pattern according to the recommendations for competitive sports, tailored to each athlete and type of sport10–12 (Figure 2). Borderline cases belonging to the “gray zone” of diagnosis between athlete's heart and arrhythmogenic RV cardiomyopathy were also judged potentially dangerous. Among these athletes, 10% (n = 14) were treated with antiarrhythmic drugs, in 1.4% (n = 2) ablation was indicated, and in 1 athlete surgical repair of the congenital defect was indicated. In the rest of the athletes, competitive sports were not recommended, and detraining was proposed (n = 26). Follow-up was feasible in 93 athletes (mean 28 months). A decrease of >70% in the number of PVCs compared to the first Holter monitoring was observed in 34 (37%), while in 31 (33%), VAs did not show significant changes, and in 28 (30%), PVCs increased. During follow-up, no athlete presented with a major cardiac event.

Bottom Line: Results of ECG were normal in most athletes (85%).Overall, 30% of athletes were judged to have potentially dangerous VAs.In conclusion, cardiac screening with noninvasive examinations remains a fundamental tool for the identification of a possible pathologic substrate and for the characterization of electrical instability.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. steriotis@hotmail.com

Show MeSH
Related in: MedlinePlus