Wenckebach second-degree A-V block in top-ranking athletes: an old problem revisited

Zeppilli, Paolo; Fenici, Riccardo; Sassara, Massimo; Pirrami, Marco Maria; Caselli, Giovanni

doi:10.1016/0002-8703(80)90140-4

Cited by 81 publications

(33 citation statements)

References 39 publications

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“…A similar finding has been reported in sedentary populations [15], whereas in athletes no such correlation was found [16,17]. Zeppilli et al [18] have hy pothesized that training has different effects on vagal fibers supplying sinus and atrioven tricular nodes. The maximal P wave ampli tude is significantly influenced by the heart rate, with the lowest value in the bradycardia and the highest in the tachycardia group which is in agreement with others [7], We found an increased incidence of nodal rhythm and ectopic beats in bradycardia, pointing to an escape phenomenon rather than a sign of pathological changes in the heart [8], Support for this interpretation can be found in the experimental study by Han et al [19] in dogs, showing an increase in ectopic beats following vagal stimulation.…”

Section: Heart Ratesupporting

confidence: 75%

Electrocardiographic Findings of Heart Rate and Conduction Times in Athletic Students and Sedentary Control Subjects

Bjørnstad¹,

Storstein²,

Meen³

et al. 1993

Cardiology

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We have investigated resting electrocardiograms in 1,299 athletic students and 151 sedentary control subjects. Bradycardia was significantly more common in athletes. The athletic group was divided according to a heart rate < 50, 50-100, and above 100 beats/min. Atrioventricular conduction time, prevalence of ectopic beats and other rhythms, parameters of right and left ventricular hypertrophy, ST elevation, and T wave amplitude were increased in the sinus bradycardia group. A significant negative correlation was found between heart rate and PQ duration in athletes. In the sinus tachycardia group, the PQ duration was shorter and the ST depression more prominent than in the other groups. The subjects were also divided according to PQ ≧ 0.22, 0.21-0.12, and < 0.12 s. Parameters of left ventricular hypertrophy were markedly increased in athletes with PQ ≧ 0.22 s, while the heart rate was only slightly decreased, suggesting an association between prolonged atrioventricular conduction time and left ventricular hypertrophy. Incomplete right bundle branch block was associated with a lower heart rate, increased duration of QRS and QTc, voltage of precordial Q waves, indices of right ventricular hypertrophy, and negative T waves. These findings are typical of right ventricular hypertrophy, indicating a close relation of incomplete right bundle branch block to right ventricular hypertrophy.

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Section: Heart Ratesupporting

confidence: 75%

Electrocardiographic Findings of Heart Rate and Conduction Times in Athletic Students and Sedentary Control Subjects

Bjørnstad¹,

Storstein²,

Meen³

et al. 1993

Cardiology

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show abstract

“…93 In the asymptomatic athletic patient with any of these common bradyarrhythmias, reassurance and documentation of an appropriate chronotropic response to exercise are typically sufficient to exclude a pathological process. 94 Advanced forms atrioventricular dissociation, such as second-degree Mobitz type II and third-degree heart block, are unusual in athletes and should be considered pathological. 95 Premature beats (both atrial and ventricular) and nonsustained ventricular tachycardia may be observed in trained athletes.…”

Section: Arrhythmiamentioning

confidence: 99%

Athlete's Heart and Cardiovascular Care of the Athlete

2011

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“…77,78 The AV block typically occurs during sleep or at rest. In asymptomatic athletes without structural heart disease (as assessed by echocardiography) and with resolution of the AV block during exercise (as assessed by 24 h Holter monitoring and/or exercise testing), no further investigations and no therapy are indicated.…”

Section: Atrioventricular Blocksmentioning

confidence: 99%