title: Cardiac arrhythmias in presidents and other athletes.
abstract: We presented examples of both supraventricular and ventricular rhythm disorders which can occur in athletic individuals, even presidents. The vast majority of rhythm problems we deal with in athletes are fortunately benign, entities such as frequent atrial ectopic beats or VPBs. In each patient encountered, we ask ourselves the five questions noted in the discussion pertaining to symptomatology, anatomic source of the arrhythmia, presence or absence of underlying cardiac disease, and precipitating factors. The most common more sustained SVTs we see are AVNRT and atrial fibrillation. Atrial flutter is less common. These are more of a nuisance to patients rather than a threat to their lives, although rarely cerebral embolic events can occur. Therapy includes avoidance of precipitating factors and, when necessary, a sequential trial of available drugs, carefully documenting the response and watching closely for any pro-arrhythmic events. We infrequently see NSVT in athletes, even triplets of VPBs on exercise testing, and rarely see instances of sustained VT. The latter merits a careful search for underlying cardiac disease and usually electrophysiology-guided drug therapy. New techniques such as radiofrequency ablation of the dysrhythmic focus may obviate the need for chronic drug therapy in selected cases.
authors.affiliation: Cardiac Rehabilitation and the Internal Medicine Residency Program, Georgia Baptist Medical Center, Atlanta 30312-1239.
authors.forename: J D
authors.initials: JD
authors.lastname: Cantwell
authors.forename: S
authors.initials: S
authors.lastname: Lammert
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D012420:Running / Q000293:injuries*