Premature ventricular beats in the athlete: management considerations

Background Whether prolonged and intense exercise increases the incidence of ventricular arrhythmias in middle-aged athletes remains to be established. Design Prospective, case-control. Methods We studied 134 healthy competitive athletes >30 years old (median age 45 (39–51) years, 83% males) who had been engaged in 9 ± 2 h per week of endurance sports activity (running, cycling, triathlon) for 13 ± 4 consecutive years. One hundred and thirty-four age- and gender-matched individuals served as controls. Both groups underwent 12-lead 24-h ambulatory electrocardiogram monitoring, which included a training session in athletes. Ventricular arrhythmias were evaluated in terms of number, complexity (i.e. couplet, triplet or non-sustained ventricular tachycardia), exercise-inducibility and morphology. Results Thirty-five (26%) athletes and 31 (23%) controls showed >10 isolated premature ventricular beats or ≥1 complex ventricular arrhythmia ( p = 0.53). Athletes with ventricular arrhythmias were older (median 48 versus 43 years old, p = 0.03) but did not differ with regard to hours of training and years of activity compared with athletes without ventricular arrhythmias. Ten (7%) athletes and six (5%) controls showed >500 premature ventricular beats/24 h ( p = 0.30): the most common ventricular arrhythmia morphologies were infundibular (six athletes and five controls) and fascicular (two athletes and one control). Conclusions The prevalence of ventricular arrhythmias at 24-hour ambulatory electrocardiogram monitoring did not differ between middle-aged athletes and sedentary controls and was unrelated to the amount and duration of exercise. These findings do not support the hypothesis that endurance sports activity increases the burden of ventricular arrhythmias. Among individuals with frequent premature ventricular beats, the predominant ectopic QRS morphologies were consistent with the idiopathic and benign nature of the arrhythmia.

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Premature ventricular beats in healthy adult subjects 20 to 79 years of age

European Heart Journal ◽

10.1093/oxfordjournals.eurheartj.a061860 ◽

1985 ◽

Vol 6 (4) ◽

pp. 335-341 ◽

Cited By ~ 17

Author(s):

V. RASMUSSEN ◽

G. JENSEN ◽

P. SCHNOHR ◽

J. FISCHER HANSEN

Keyword(s):

Healthy Adult ◽

Premature Ventricular Beats

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PCA Representation of ECG Signal as a Useful Tool for Detection of Premature Ventricular Beats in 3-Channel Holter Recording by Neural Network and Support Vector Machine Classifier

Biological and Medical Data Analysis - Lecture Notes in Computer Science ◽

10.1007/978-3-540-30547-7_27 ◽

2004 ◽

pp. 259-268 ◽

Cited By ~ 1

Author(s):

Stanisław Jankowski ◽

Jacek J. Dusza ◽

Mariusz Wierzbowski ◽

Artur Oręziak

Keyword(s):

Neural Network ◽

Support Vector Machine ◽

Support Vector Machine Classifier ◽

Support Vector ◽

Ecg Signal ◽

Premature Ventricular Beats

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Workload monitoring and athlete management

Advanced Strength and Conditioning ◽

10.4324/9781315542348-9 ◽

2017 ◽

pp. 137-150

Author(s):

Tim J. Gabbett

Keyword(s):

Athlete Management

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Impact of ventricular arrhythmias on survival in patients after myocardial infarction

International Journal of Diagnostic Imaging ◽

10.5430/ijdi.v1n1p21 ◽

2014 ◽

Vol 1 (1) ◽

pp. 21 ◽

Cited By ~ 1

Author(s):

Katarzyna Anna Mitręga ◽

Agnieszka Kolczyńska ◽

Joanna Hanzel ◽

Sylwia Cebula ◽

Stanisław Morawski ◽

...

Keyword(s):

Myocardial Infarction ◽

Risk Factor ◽

Ventricular Arrhythmias ◽

Independent Risk Factor ◽

Premature Ventricular Beats ◽

Large Numbers ◽

Ventricular Extrasystoles ◽

Long Term Follow Up

Introduction: Despite the continuous development of new methods of pharmacological and invasive treatment for patients with acute myocardial infarction (MI) the prognosis of long-term survival is still uncertain. Therefore, there is still need to look for new noninvasive predictors of death in patients after MI. Aim: To analyze the prognostic value of ventricular arrhythmias in predicting mortality following MI in long-term follow-up. Methods: We analyzed 390 consecutive patients (114 females and 276 males, aged 63.9 ± 11.15 years, mean EF: 43.8 ± 7.9%) with MI treated invasively. On the 5th day after MI 24-hour digital Holter recording was performed to assess the number of premature ventricular beats (VPB) and their sustained forms such as: salvos and nonsustained ventricular tachycardia (nsVT < 30 s). The large numbers of ventricular extrasystoles: ≥ 10 VPB / hour were considered as abnormal. In echocardiography the size of heart cavities and cardiac contractile function were evaluated. Within 30.1 ± 15.1 months of follow-up 38 patients died. Results: In the group of patients with MI the mean value of ventricular ectopy during the day was: 318.8 ± 1447.6. Large numbers of ventricular extrasystoles were observed in 75% patients, while nsVT in 6% patients. Significant differences in the incidence of death after MI were observed in patients with nsVT and ventricular salvos. In the group of patients who died in comparison to the group of patients who survived in long-term follow-up, a significantly less ventricular ectopic incidence was noted (9.83% vs 90.17%, p < 0.01). In patients who died after MI more premature ventricular beats (≥ 10 VPB / h) and a greater nsVT incidence were observed; however not significant. Moreover, in patients with MI the systolic and diastolic LV dimension, decreased values of hemoglobin, salvos and nsVT incidence are the independent risk factors of death. The strongest independent risk factor of death after MI is salvos (HR: 1.32, P < 0.01). Conclusions: In long term follow-up the largest differences in death were observed in patients with ventricular salvos and nsVT. Furthermore, ventricular salvos are the strongest independent risk factor of death in patients with AMI.

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