title: Noninvasive cardiac screening in young athletes with ventricular arrhythmias.
abstract: The aim of this study was to analyze using noninvasive cardiac examinations a series of young athletes discovered to have ventricular arrhythmias (VAs) during the preparticipation screening program for competitive sports. One hundred forty-five athletes (mean age 17 ± 5 years) were evaluated. The study protocol included electrocardiography (ECG), exercise testing, 2-dimensional and Doppler echocardiography, 24-hour Holter monitoring, signal-averaged ECG, and in selected cases contrast-enhanced cardiac magnetic resonance imaging. Results of ECG were normal in most athletes (85%). VAs were initially detected prevalently during exercise testing (85%) and in the remaining cases on ECG and Holter monitoring. Premature ventricular complexes disappeared during exercise in 56% of subjects. Premature ventricular complexes during Holter monitoring averaged 4,700 per day, predominantly monomorphic (88%), single, and/or in couplets (79%). The most important echocardiographic findings were mitral valve prolapse in 29 patients (20%), congenital heart disease in 4 (3%), and right ventricular regional kinetic abnormalities in 5 (3.5%). On cardiac magnetic resonance imaging, right ventricular regional kinetic abnormalities were detected in 9 of 30 athletes and were diagnostic of arrhythmogenic right ventricular cardiomyopathy in only 1 athlete. Overall, 30% of athletes were judged to have potentially dangerous VAs. In asymptomatic athletes with prevalently normal ECG, most VAs can be identified by adding an exercise test during preparticipation screening. In conclusion, cardiac screening with noninvasive examinations remains a fundamental tool for the identification of a possible pathologic substrate and for the characterization of electrical instability.
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. steriotis@hotmail.com
authors.forename: Alexandros Klavdios
authors.initials: AK
authors.lastname: Steriotis
authors.forename: Andrea
authors.initials: A
authors.lastname: Nava
authors.forename: Ilaria
authors.initials: I
authors.lastname: Rigato
authors.forename: Elisa
authors.initials: E
authors.lastname: Mazzotti
authors.forename: Luciano
authors.initials: L
authors.lastname: Daliento
authors.forename: Gaetano
authors.initials: G
authors.lastname: Thiene
authors.forename: Cristina
authors.initials: C
authors.lastname: Basso
authors.forename: Domenico
authors.initials: D
authors.lastname: Corrado
authors.forename: Barbara
authors.initials: B
authors.lastname: Bauce
mesh_terms: D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D056352:Athletes; D002648:Child; D015150:Echocardiography, Doppler / Q000379:methods*; D015716:Electrocardiography, Ambulatory / Q000379:methods*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D010808:Physical Examination / Q000379:methods*; D015203:Reproducibility of Results; D055815:Young Adult