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Long-term clinical significance of frequent and complex ventricular tachyarrhythmias in trained athletes

Alessandro Biffi, MD^*,*, Antonio Pelliccia, MD^*, Luisa Verdile, MD^*, Fredrick Fernando, MD^*, Antonio Spataro, MD^*, Stefano Caselli, MD^*, Massimo Santini, MD and Barry J. Maron, MD, FACC

^* Institute of Sports Science, Department of Medicine, Italian National Olympic Committee, Rome, Italy
San Filippo Neri Hospital, Department of Heart Disease, Rome, Italy
Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA

View larger version (62K): [in a new window]   Figure 1 Segment of 24-h Holter electrocardiogram recording from a 24-year-old male basketball player with history of frequent palpitations. (Top) Asymptomatic 10-beat burst of nonsustained ventricular tachycardia (shortest R-R interval, 300 ms). Intervals between the initial beat and subsequent ectopic beats gradually shorten as the rate of discharge of the ectopic focus increases. The electrophysiologic study with programmed ventricular stimulation was normal. (Bottom) Hourly profile of premature ventricular depolarizations (PVDs) over 24 h. There is a total of 12,186 PVDs during a 24 h period largely without significant differences between the morning and evening. Only during a training session (at 3 PM) was there a distinctly reduced number of PVDs (200/h).

View larger version (91K): [in a new window]   Figure 2 Resting 12-lead electrocardiogram (ECG) showing left bundle branch block premature ventricular depolarization pattern and inferiorly oriented QRS axis from an asymptomatic 27-year-old soccer player. Otherwise, ECG pattern is normal. Noninvasive testing excluded underlying cardiovascular abnormalities.