Ventricular arrhythmias at risk of sudden cardiac death in young athletes. Non invasive cardiac examinations during preparticipation screening for sport eligibility.

摘要: Background: the pre-participation screening program of athletes has goal early identification previously unsuspected cardiovascular diseases with a prompt disqualification from competitive physical activity. The most frequent disqualifying condition consists rhythm and conduction abnormalities (nearly 40%). Aim study methods: non-invasive cardiac examinations young discovered to have ventricular arrhythmias during preparticipation program. A total 145 (<35 years) (M/F=106/39=2.7, mean age 17.3±5.3 were evaluated in outpatient clinic department Cardiology Padua University years 2007 2010. All subjects referred our laboratory due detected preparticipations screening, through 12 lead-ECG or exercise stress test ECG-Holter monitoring. protocol included family personal history, 12-lead basal ECG, echocardiography-Doppler, monitoring, test, signal-averaged magnetic resonance (CMR). Moreover selected cases invasive examination genetic performed. When available, follow-up was also reported. Results: In 15% ECG pathologic. Negative T-waves beyond V2 present 2.1% associated presence disease. Late potentials 6.8%. Frequent echocardiographic findings right left enlargement, mitral valve prolapse mild atrioventricular regurgitation. Congenital 2.7%. possible form cardiomyopathy identified 2.1%. Premature beats (PVBs) more frequently monomorphic (88%) isolated (57%). Rapid tachycardia rare (2.7%). During PVBs disappeared 55.7%, only recovery 11.5%, persisted 8.6% exercise-induced 13.7%. Most morphology LBBB inferior axis deviation. segmental on CMR, almost half which it performed, is not always easy interpretate needed. Overall 30% judged potentially dangerous 10% antiarrhythmic therapy initiated. 44% put detraining disqualified. Conclusion: identifies arrhythmias, are be dangerous. submaximal important tools that allow sports, thus should accompany first level evaluation an athlete. Cardiologic techniques fundamental for no known organic heart disease, suspected channelopathy idiopathic as may harmful either progression disease arrhythmic death. Follow-up demonstrated athletes, pharmacologic sport squalification, can prevent adverse outcomes. Collaboration sports medicine cardiology permits prevention sudden Risk stratification remains difficult even after thorough investigation all available.