Ventricular arrhythmias in athletes : Role of a comprehensive diagnostic workup
Copyright © 2021 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Ventricular arrhythmias (VAs) represent a critical issue with regard to sports eligibility assessment in athletes. The ideal diagnostic evaluation of competitive and leisure-time athletes with complex VAs has not been clearly defined.
OBJECTIVE: The purpose of this study was to assess the clinical implications of invasive electrophysiological assessments and endomyocardial biopsy (EMB) among athletes with VAs.
METHODS: We evaluated 227 consecutive athletes who presented to our institutions after being disqualified from participating in sports because of VAs. After noninvasive tests, electrophysiological study (EPS), electroanatomic mapping (EAM), and EAM- or cardiac magnetic resonance imaging-guided EMB was performed, following a prespecified protocol. Sports eligibility status was redefined at 6-month follow-up.
RESULTS: From our sample, 188 athletes (82.8%) underwent EAM and EPS, and 42 (15.2%) underwent EMB. A diagnosis of heart disease could be formulated in 30% of the study population (67/227; 95% confidence interval [CI] 0.24-0.36) after noninvasive tests; in 37% (83/227; 95% CI 31%-43%) after EPS and EAM; and in 45% (102/227; 95% CI 39%-51%) after EMB. In the subset of athletes undergoing EMB, invasive diagnostic workup allowed diagnostic reclassification of half of the athletes (n = 21 [50%]). Reclassification was particularly common among subjects without definitive findings after noninvasive evaluation (n = 23; 87% reclassified). History of syncope, abnormal echocardiogram, presence of late gadolinium enhancement, and abnormal EAM were linked to sports ineligibility at 6-month follow-up.
CONCLUSION: A comprehensive invasive workup provided additional diagnostic elements and could improve the sports eligibility assessment of athletes presenting with VAs. The extensive invasive evaluation presented could be especially helpful when noninvasive tests show unclear findings.
| Errataetall: |
CommentIn: Heart Rhythm. 2022 Jan;19(1):100-101. - PMID 34563691 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:19 |
|---|---|
| Enthalten in: |
Heart rhythm - 19(2022), 1 vom: 01. Jan., Seite 90-99 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Dello Russo, Antonio [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Arrhythmogenic right ventricular cardiomyopathy |
|---|
| Anmerkungen: |
Date Completed 11.03.2022 Date Revised 11.03.2022 published: Print-Electronic CommentIn: Heart Rhythm. 2022 Jan;19(1):100-101. - PMID 34563691 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.hrthm.2021.09.013 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM330785192 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM330785192 | ||
| 003 | DE-627 | ||
| 005 | 20231225212031.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.hrthm.2021.09.013 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1102.xml |
| 035 | |a (DE-627)NLM330785192 | ||
| 035 | |a (NLM)34536590 | ||
| 035 | |a (PII)S1547-5271(21)02115-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Dello Russo, Antonio |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Ventricular arrhythmias in athletes |b Role of a comprehensive diagnostic workup |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 11.03.2022 | ||
| 500 | |a Date Revised 11.03.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Heart Rhythm. 2022 Jan;19(1):100-101. - PMID 34563691 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Ventricular arrhythmias (VAs) represent a critical issue with regard to sports eligibility assessment in athletes. The ideal diagnostic evaluation of competitive and leisure-time athletes with complex VAs has not been clearly defined | ||
| 520 | |a OBJECTIVE: The purpose of this study was to assess the clinical implications of invasive electrophysiological assessments and endomyocardial biopsy (EMB) among athletes with VAs | ||
| 520 | |a METHODS: We evaluated 227 consecutive athletes who presented to our institutions after being disqualified from participating in sports because of VAs. After noninvasive tests, electrophysiological study (EPS), electroanatomic mapping (EAM), and EAM- or cardiac magnetic resonance imaging-guided EMB was performed, following a prespecified protocol. Sports eligibility status was redefined at 6-month follow-up | ||
| 520 | |a RESULTS: From our sample, 188 athletes (82.8%) underwent EAM and EPS, and 42 (15.2%) underwent EMB. A diagnosis of heart disease could be formulated in 30% of the study population (67/227; 95% confidence interval [CI] 0.24-0.36) after noninvasive tests; in 37% (83/227; 95% CI 31%-43%) after EPS and EAM; and in 45% (102/227; 95% CI 39%-51%) after EMB. In the subset of athletes undergoing EMB, invasive diagnostic workup allowed diagnostic reclassification of half of the athletes (n = 21 [50%]). Reclassification was particularly common among subjects without definitive findings after noninvasive evaluation (n = 23; 87% reclassified). History of syncope, abnormal echocardiogram, presence of late gadolinium enhancement, and abnormal EAM were linked to sports ineligibility at 6-month follow-up | ||
| 520 | |a CONCLUSION: A comprehensive invasive workup provided additional diagnostic elements and could improve the sports eligibility assessment of athletes presenting with VAs. The extensive invasive evaluation presented could be especially helpful when noninvasive tests show unclear findings | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Arrhythmogenic right ventricular cardiomyopathy | |
| 650 | 4 | |a Athletes | |
| 650 | 4 | |a Electroanatomic mapping | |
| 650 | 4 | |a Endomyocardial biopsy | |
| 650 | 4 | |a Myocarditis | |
| 650 | 4 | |a Ventricular arrhythmias | |
| 700 | 1 | |a Compagnucci, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Casella, Michela |e verfasserin |4 aut | |
| 700 | 1 | |a Gasperetti, Alessio |e verfasserin |4 aut | |
| 700 | 1 | |a Riva, Stefania |e verfasserin |4 aut | |
| 700 | 1 | |a Dessanai, Maria Antonietta |e verfasserin |4 aut | |
| 700 | 1 | |a Pizzamiglio, Francesca |e verfasserin |4 aut | |
| 700 | 1 | |a Catto, Valentina |e verfasserin |4 aut | |
| 700 | 1 | |a Guerra, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a Stronati, Giulia |e verfasserin |4 aut | |
| 700 | 1 | |a Andreini, Daniele |e verfasserin |4 aut | |
| 700 | 1 | |a Pontone, Gianluca |e verfasserin |4 aut | |
| 700 | 1 | |a Bonomi, Alice |e verfasserin |4 aut | |
| 700 | 1 | |a Rizzo, Stefania |e verfasserin |4 aut | |
| 700 | 1 | |a Di Biase, Luigi |e verfasserin |4 aut | |
| 700 | 1 | |a Capucci, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Natale, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Basso, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Fiorentini, Cesare |e verfasserin |4 aut | |
| 700 | 1 | |a Zeppilli, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Tondo, Claudio |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Heart rhythm |d 2004 |g 19(2022), 1 vom: 01. Jan., Seite 90-99 |w (DE-627)NLM154896640 |x 1556-3871 |7 nnns |
| 773 | 1 | 8 | |g volume:19 |g year:2022 |g number:1 |g day:01 |g month:01 |g pages:90-99 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.hrthm.2021.09.013 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 19 |j 2022 |e 1 |b 01 |c 01 |h 90-99 | ||