Exercise-induced alterations of signal-averaged electrocardiograms in marathon runners

Late potentials have been shown to predict malignant ventricular arrhythmias and sudden cardiac death. To determine whether prolonged, strenuous activity is associated with the development of ventricular late potentials, signal-averaged electrocardiography was performed on 30 marathon runners before, immediately after, and during a recovery period at least 1 week after they had a 26.2-mile race. The filtered QRS duration decreased immediately after the marathon to 94.4 +/- 10.0 msec from baseline values of 97.3 +/- 10.1 msec (p less than 0.005). Root mean square energy in the terminal 40 msec of the QRS complex increased immediately after the race from 60.4 +/- 35.6 uV to 71.0 +/- 41.7 uV (P less than 0.5). The duration of signals less than 40 uV in the terminal QRS were not appreciably altered. At the 1-week follow-up study, all parameters closely approximated the baseline values. No runner had a late potential after running the race. The one runner with a late potential at baseline had normal parameters immediately after the race. We conclude that signal-averaged ECG parameters are improved after a marathon is run, and the risk of an arrhythmic sudden death in adult runners without organic heart disease would seem to be low.