Long-term follow-up of bradycardia in elite athletes

The aim of the study was to examine the hypothesis that when former high-level athletes retired from competition, bradycardia would vanish. ECG changes and factors possibly related to the persistence of bradycardia were investigated. We performed a longitudinal follow-up study in 157 former elite athletes who had records of bradycardia < 50 bpm when they were active in high-level competition. All had retired from competitive sport for a minimum of five years prior to participation in the follow-up examination. Data on sport modality, hours of weekly training during competition periods, years participating in high-level competition, and years since retirement from competition were abstracted from medical records at two sports medicine centers. ECGs from this time were studied. At the post-retirement follow-up examination, participants underwent a clinical examination that included blood pressure and ECG recordings, and answered a structured questionnaire about their physical exercise since retirement from their sporting career. In the post-retirement period, a total of 65 % of participants had persistent bradycardia, 18 % with bradycardia < 50 bpm. Multivariate analysis showed that persistence of resting bradycardia was associated with regular exercise and number of years in high-level competition, but not with symptoms such as palpitations, dizziness or syncope, or major ECG alterations.