Athletes with multiple and even complex ventricular ectopic beats without structural abnormalities are at low risk for sudden cardiac death and need not forgo competition, according to the results of a study reported in the Aug. 7 issue of the Journal of the American College of Cardiology.
“Frequent and complex ventricular tachyarrhythmias are common in trained athletes and are usually unassociated with underlying cardiovascular abnormalities,” write Alessandro Biffi, MD, and colleagues from the Institute of Sports Science, Italian National Olympic Committee, in Rome.
“Such ventricular arrhythmias (VAs)…do not convey adverse clinical significance, appear to be an expression of ‘athlete’s heart syndrome,’ and probably do not per se justify a disqualification from competitive sports.”
In this prospective study taking place from 1984 to 1999, 355 competitive athletes with VAs on a 24-hour ambulatory Holter ECG were divided into three groups. Indications for the Holter were palpitations, at least three premature ventricular depolarizations (PVDs) on resting 12-lead ECG, or both. Group A (n=71) had at least 2,000 PVDs per 24 hours; Group B (n=153) had between 100 and 2,000 PVDs per 24 hours; and Group C (n=131) had fewer than 100 PVDs per 24 hours.
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