Purpose: To examine the internal and external load imposed by long sprint ability–oriented small-sided games (SSG) using different ratios of players to pitch area (densities) in soccer players. Methods: A total of 19 professional soccer players from the same soccer club (age = 17.1 [0.3] y, height = 1.76 [0.69] m, and body mass = 69.7 [9.4] kg) participated in this study. Players performed 4 × 30-s (150 s recovery) all-out 1-vs-1 SSG considering 300, 200, and 100 m2 per player (48 h apart). Players’ external loads were tracked with global positioning technology (20 Hz). Heart rate, blood lactate concentration (BLc), and rating of perceived exertion characterized players’ internal load. Peak BLc was assessed with a 30-s all-out test on a nonmotorized treadmill (NMT). Results: SSG300 produced higher BLc than SSG200 (moderate) and SSG100 (large). The SSG300, SSG200, and SSG100 BLc were 97.8% (34.8%), trivial; 74.7% (24.9%), moderate; and 43.4% (15.7%), large, of the NMT30s peak BLc, respectively. Players covered more distance at high intensity during the SSG300 than in other SSG conditions (huge to very large differences). High-intensity deceleration distance was largely lower in SSG200 than in SSG300. SSG100 elicited very large to huge and large to very large lower external load values than SSG300 and SSG200, respectively. Conclusions: The main finding of this study showed an inverse association between ball-drill density and internal/external loads in long sprint ability–oriented SSG. The SSG300 provided BLc closer to individual maximal, thus satisfying the all-out construct assumed for the development of long sprint ability. Further studies using the SSG300 as a training intervention and/or investigating other different SSG formats using the same density are warranted.

The traditional transvenous defibrillator has been one of the greatest advancement in Cardiology in the last 30 years and has demonstrated to reduce arrhythmic and total mortality in selected patients. However the traditional defibrillator can have a high price to pay in terms of complications, the “weakest link” being the transvenous/endocardial leads. The entirely subcutaneous defibrillator (S-ICD) has recently entered into the clinical scenario and represents a valid alternative to the transvenous device. S-ICD can provide substantial advantages, especially among some subgroups of patients (i.e. after device infection, in young patients and arrhythmogenic syndromes). However, given its characteristics, it is fundamental to choose patients that can benefit the most. In this review we will describe advantages and limitations of the S-ICD and point-out how to select the “ideal candidate” for the implantation.

S-ICD is a new system for delivering lifesaving shock therapy in patients at risk of sudden cardiac death, without the need of intracardiac leads. Young patients with inherited arrhythmogenic syndromes could benefit the most from this system. This is the first case of Brugada syndrome implanted with a first-generation S-ICD in Italy.

Implantable cardioverter defibrillator (ICD) programming involves several parameters. In recent years antitachycardia pacing (ATP) has gained an increasing importance in the treatment of ventricular arrhythmias, whether slow or fast. It reduces the number of unnecessary and inappropriate shocks and improves both patient’s quality of life and device longevity. There is no clear indication regarding the type of ATP to be used, except for the treatment of fast ventricular tachycardias (188 bpm-250 bpm) where it has been shown a greater efficacy and safety of burst compared to ramp; 8 impulses in each sequence of ATP appears to be the best programming option in this setting. Beyond ATP use, excellent clinical results were obtained with programming standardization following these principles: extended detection time in ventricular fibrillation (VF) zone; supraventricular discrimination criteria up to 200 bpm; first shock in VF zone at the maximum energy in order to reduce the risk of multiple shocks. The MADIT-RIT trial and some observational registries have also recently demonstrated that programming with a widespread use of ATP, higher cut-off rates or delayed intervention reduces the number of inappropriate and unnecessary therapies and improves the survival of patients during mid-term follow-up.

No abstract