Do ventricular arrhythmias in athletes subside over time?

Area of Science:

• Cardiology
• Sports Medicine
• Exercise Physiology

Background:

• Sudden death in athletes is a concern, often linked to ventricular arrhythmias during physical activity.
• Understanding the long-term prognosis of athletes experiencing these arrhythmias is crucial for risk stratification.

Purpose of the Study:

• To examine the long-term outcomes of athletes diagnosed with ventricular arrhythmias during exercise testing.
• To compare the incidence and severity of arrhythmias in athletes over time, correlating with changes in sport participation.

Main Methods:

• A cohort of 192 athletes with exercise-induced ventricular arrhythmias (ventricular premature beats, couplets, or non-sustained ventricular tachycardia) was identified from a database of 56,462 athletes.
• A control group of 92 athletes without arrhythmias was selected. A subset of 39 athletes with arrhythmias underwent repeat exercise testing after a mean follow-up of 70 months.

Main Results:

• Athletes who experienced ventricular arrhythmias during initial testing showed a significant reduction in arrhythmias during follow-up testing (P = 0.001).
• A decrease in competitive sport engagement was observed from initial to follow-up testing (P = 0.021).
• Peak heart rate during follow-up exercise tests was significantly lower (P = 0.001).

Conclusions:

• Athletes participating in competitive sports have a higher likelihood of developing exercise-induced ventricular arrhythmias.
• Ventricular arrhythmias in athletes tend to resolve or diminish over time, particularly with a transition to non-competitive physical activities.