Intrinsic Sinus Node/Atrioventricular Node Dysfunction Requiring Pacemaker Implantation: Role of Former Professional...

Area of Science:

• Cardiology
• Sports Medicine
• Electrophysiology

Background:

• Sinus bradycardia and atrioventricular (AV) block in athletes are often considered adaptive.
• However, these conditions can persist and become pathological after detraining.
• This study investigates former professional athletes requiring pacemaker implantation.

Purpose of the Study:

• To compare former professional athletes needing pacemakers with sedentary controls.
• To identify characteristics of sinus node (SN) dysfunction or AV block in this cohort.
• To assess if athletic training influences the development of these conditions.

Main Methods:

• Retrospective analysis of patients undergoing pacemaker (PM) implantation in 2022.
• Comparison of 18 former professional athletes (Group 1) with 20 sedentary individuals (Group 2) and 323 other patients (Group 3).
• Analysis of age at diagnosis, PM implantation, and type of bradyarrhythmia.

Main Results:

• No significant age difference in PM implantation between former athletes and sedentary controls.
• Former endurance athletes were diagnosed and received PMs at a significantly younger age.
• Endurance athletes showed a higher prevalence of second or third-degree AV block (78%) compared to power/mixed athletes (44%).

Conclusions:

• Idiopathic SN dysfunction/AV block occurred earlier in former endurance athletes.
• Intense, prolonged endurance sports may lead to non-benign bradycardia and AV block.
• These findings challenge the assumption of solely adaptive cardiac changes in elite endurance athletes.