The Congenital Long QT Syndrome and Implications for Young Athletes

Kapetanopoulos, Athanasios; Kluger, Jeffrey; Maron, Barry J.; Thompson, Paul D.

doi:10.1249/01.mss.0000218130.41133.cc

Cited by 35 publications

(17 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The various types of congenital long QT syndromes have an estimated prevalence of 1:5,000 in the general population. Studies on competitive athletes indicated similar prevalence [4,25]. Approximately 10% of patients with long QT syndrome die due to sudden cardiac death.…”

Section: Genetic Defectsmentioning

confidence: 95%

Possible mechanisms of sudden cardiac death in top athletes: a basic cardiac electrophysiological point of view

Varró

Baczkó

2010

Pflugers Arch - Eur J Physiol

View full text Add to dashboard Cite

Sudden death among athletes is very rare (1:50,000-1:100,000 annually) but it is still 2-4 times more frequent than in the age-matched control population and attracts significant media attention. We propose a mechanism underlying sudden cardiac death in athletes that does not relate to myocardial ischemia but is based on repolarization abnormalities due to potassium channel downregulation and can also be best explained by the concurrent presence of several factors such as cardiac hypertrophy (athlete's heart), and/or hypertrophic cardiomyopathy, increased sympathetic tone, genetic defects, drugs, doping agents, food, or dietary ingredients. These factors together can increase the repolarization inhomogeneity of the heart ("substrate") and an otherwise harmless extrasystole ("trigger") occurring with a very unfortunate timing may sometimes induce life-threatening arrhythmias. The effective and possible prevention of sudden cardiac death requires the development of novel cost effective cardiac electrophysiological screening methods. Athletes identified by these tests as individuals at higher proarrhythmic risk should then be subjected to more costly genetic tests in order to uncover possible underlying genetic causes for alterations in ionic channel structure and/or function.

show abstract

Section: Genetic Defectsmentioning

confidence: 95%

Possible mechanisms of sudden cardiac death in top athletes: a basic cardiac electrophysiological point of view

Varró

Baczkó

2010

Pflugers Arch - Eur J Physiol

View full text Add to dashboard Cite

show abstract

“…[26][27][28][29][30] In health, adequate coronary blood flow reserve and normal cardiac electrical activity occur during vigorous exercise. However, in the presence of coronary artery disease, the production of malignant substrates during or immediately after exercise stress might trigger a cascade of physiological events precipitating an adverse event (Fig.…”

Section: Pathophysiology Of Exercise-induced Adverse CV Eventsmentioning

confidence: 99%

The Acute Risks of Exercise in Apparently Healthy Adults and Relevance for Prevention of Cardiovascular Events

Goodman

Burr

Banks

et al. 2016

Canadian Journal of Cardiology

View full text Add to dashboard Cite

“…Exercise testing may enhance diagnostic accuracy because shortening of the QT interval during effort is inadequate and/or repolarisation abnormalities become more prominent and recognisable after exercise (in the recovery phase) in patients with LQTS. The ECG response to exercise may vary according to LQTS genotype: the QTc prolongs in LQT1, remains unchanged in LQT2, and shortens excessively in LQT3 patients 69. Athletes with a clear-cut prolonged QTc interval should be referred to a cardiac specialist for definitive diagnosis and risk stratification of LQTS, including molecular screening of causative gene mutations.…”

Section: Uncommon and Training-unrelated Ecg Changesmentioning

confidence: 99%

12-lead ECG in the athlete: physiological versus pathological abnormalities

Biffi²,

et al. 2009

View full text Add to dashboard Cite

Participation in sports activity and regular physical training is associated with physiological structural and electrical changes in the heart (athlete's heart) that enable sustained increases in cardiac output for prolonged periods. Cardiovascular remodelling in the conditioned athlete is often associated with ECG changes. In rare cases, abnormalities of an athlete's ECG may reflect an underlying heart disease which puts the athlete at risk of arrhythmic cardiac arrest during sport. It is mandatory that ECG abnormalities resulting from intensive physical training and those of a potential cardiac pathology are properly defined. This article provides a modern approach to interpreting 12-lead ECGs of athletes based on recently published new findings. The main objective is to distinguish between physiological adaptive ECG changes and pathological ECG abnormalities. The most important aims are to prevent physiological changes in the athlete being erroneously attributed to heart disease, or signs of life-threatening cardiovascular conditions being dismissed as a normal variant of athlete's heart. As pathological ECG abnormalities not only cause alarm but also require action with additional testing to exclude (or confirm) the suspicion of a lethal cardiovascular disorder, appropriate interpretation of an athlete's ECG will prevent unnecessary distress and also result in considerable cost saving in the context of a population-based preparticipation screening programme.

show abstract

The Congenital Long QT Syndrome and Implications for Young Athletes

Cited by 35 publications

References 45 publications

Possible mechanisms of sudden cardiac death in top athletes: a basic cardiac electrophysiological point of view

Possible mechanisms of sudden cardiac death in top athletes: a basic cardiac electrophysiological point of view

The Acute Risks of Exercise in Apparently Healthy Adults and Relevance for Prevention of Cardiovascular Events

12-lead ECG in the athlete: physiological versus pathological abnormalities

Contact Info

Product

Resources

About