[Electrocardiographic features of the athlete: what are the limits?]

The athlete's heart syndrome concerns only high level trained subjects. The classical electrocardiographic features of this syndrome are hypokinetic arrhythmia as bradycardia, low level of atrioventricular and of right bundle branch block and electrocardiographic T wave alterations. Sometimes, marked ventricular repolarisation alterations can suggest the presence of heart disease. These electrocardiographic patterns seem linked to the alterations of the two drive of autonomic nervous system (sympathetic and parasympathetic) and to cardiac hypertrophy. In all cases, it must be kept in mind that the athlete must be free of clinical symptoms and that these electrocardiographic alterations must disappear during exercise and in case of physical training cessation. In case of doubt a cardiologist judgement must be performed.