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Catheter ablation in competitive athletes: indication
F Furlanello1, A Bertoldi, G Inama
1Divisione di Cardiologia e Centro Aritmologico O.C.S. Chiara, Trento, Italy.
Journal of Interventional Cardiology
|November 4, 1995
Summary
Radiofrequency ablation (RFA) is crucial for athletes with supraventricular tachyarrhythmias (SVT), especially Wolff-Parkinson-White syndrome (WPW), to ensure career eligibility. RFA offers a path to continued participation when drug treatments are incompatible with sports.
Area of Science:
- Cardiology
- Sports Medicine
- Electrophysiology
Background:
- Supraventricular tachyarrhythmias (SVT), including those associated with Wolff-Parkinson-White syndrome (WPW), can pose significant risks to athletes' careers and lives.
- Italian law prohibits antiarrhythmic drug treatment (AAD) for athletes, necessitating alternative solutions for managing SVT.
- Radiofrequency ablation (RFA) presents a unique treatment option for athletes, prioritizing their eligibility for professional sports.
Purpose of the Study:
- To define the specific indications for radiofrequency ablation (RFA) in athletes diagnosed with supraventricular tachyarrhythmias (SVT).
- To analyze a 20-year cohort of athletes to establish evidence-based criteria for RFA.
- To prioritize athlete eligibility and career continuation in treatment decisions.
Main Methods:
- A retrospective analysis of 1,325 athletes evaluated over a 20-year period (1974-1993) using a standardized cardioarrhythmological protocol.
- Subgroup analysis included athletes with Wolff-Parkinson-White syndrome (WPW), aborted sudden death, and elite professional athletes (TLA).
- Evaluation of transesophageal atrial pacing (TAP) during exercise for reproducing paroxysmal junctional reentrant tachycardia.
Main Results:
- Key indications for RFA in athletes include asymptomatic WPW at risk, symptomatic WPW during activity, and paroxysmal junctional reentrant tachycardia that compromises performance.
- WPW syndrome was present in 28.7% of the studied athletes.
- Consideration of RFA side-effects, recurrence, recovery time, and natural history of tachyarrhythmias is essential for individual athlete management.
Conclusions:
- Radiofrequency ablation (RFA) is a primary therapeutic option for athletes with supraventricular tachyarrhythmias (SVT), particularly WPW, to ensure sports eligibility.
- The decision to perform RFA must balance the risks of the arrhythmia against potential RFA complications and the athlete's career.
- Careful patient selection and consideration of individual factors are paramount for successful RFA outcomes in athletes.