Prevalence of physiological and pathological electrocardiographic findings in Hungarian athletes

Abstract

In Hungary, ECG is a keystone of routine athletic screening. Its significance is based on simplicity, quickness and high informative value as well as the fact that appearance of pathological ECG signs can precede the formation of structural heart diseases. During screening of healthy athletes, we studied the incidence of athletic ECG changes and pathological ECG abnormalities. Methods: We performed detailed analysis of 12-lead ECG recordings of asymptomatic elite, non-elite and master athletes and controls. Results: 227 athletes (male: 180, age: 27.2±8.7 years) and 89 controls (male: 57, age: 28.1±6.8 years) were examined. Benign ECG signs: sinus bradycardia, early repolarization and isolated Voltage criteria of left ventricular hypertrophy were common and more often in athletes compared to controls. Potentially pathological ECG signs: ST-(6.6% vs. 1.1%, p < 0.05) and T-wave (15.0% vs. 5.6%, p < 0.05) changes and signs of pathological left ventricular hypertrophy (5.3% vs. 0%, p < 0.05) occurred more frequently in athletes compared to controls. Conclusions: Signs of pathological left ventricular hypertrophy and repolarization abnormalities are more often in athletes. No structural heart disease could be verified in the background of the disorders. However, athletes having pathological ECG should be kept under tight cardiology control. Exact definition and widespread knowledge of pathological ECG changes is essential in early recognition of high risk athletes.

A novel marker to determine arrhytmia risk in elite cyclists: T peak T end

“…The appearance of both repolarization disorders and isolated voltage criteria of left ventricular hypertrophy indicates pathological left ventricular hypertrophy in athletes. These abnormalities can also refer to structural heart diseases, which can lead to rhythm disorder (19). Some novel datas have demonstrated an increased prevalence of ventricular arrhythmias in endurancetrained active athletes and particularly in veterans (26).…”

“…Echocardiography is a standard diagnostic tool which is used in order to differentiate the pathological and physiological LVH. In pathological cardiac hypertrophies, on a cellular level, myocardial fibers grow, cellular metabolism and cardiac structure change, myocardial dysfunction occurs, ultimately mortality and morbidity increase (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). In pathological hypertrophy, electrophysiological properties of cardiomyocytes change and high susceptibility to malignant tachyiarrhythmias occurs.…”

Nontraumatic Splenic Rupture

“…For example, a well-conditioned athlete presenting with states of shock due to splenic rupture may not show signs of tachycardia. 6…”

Signs of athletic adaptation on the electrocardiogram (ECG) = Az edzettség szív-adaptációnak jelei nyugalmi EKG-n

“…Incomplete right bundle branch block (IRBBB) is present in approximately one third of all athletes Kiss et al, 2015). Frequent signs are the R-R' morphology (rsR') in V1 lead and wide S wave in leads I and V6.…”

“…Ajmalin is a sodium channel blocker and in Brugada patients its administration results in the appearance of Type 1 ECG signs and/or ventricular tachycardia. Although Brugada syndrome is a rather rare disease (incidence: 1: 2.000-5.000), its importance is emphasized by the fact, that in elite athlete IRBBB and early repolarization may be present with Brugada-like Atrial tachyarrhytmias, ventricular arrhythmias and extrasystole definitely need further medical tests in athletes (Kiss et al, 2015). In paroxysmal supraventricular tachycardia cases (AVNRT, AVRT, atrial tachycardia) ablation therapy is needed and if it is followed by a three month symptomless period, elite athletic activity is not limited from medical reasons.…”