Athletes enjoy excellent health outcomes including greater longevity relative to non-athletic
counterparts. Paradoxically, however, endurance athletic conditioning is associated
with an increase in some arrhythmias. This review discusses the potential mechanisms
for this paradox and strategies enabling early identification of potentially serious
pathologies. Screening remains contentious due to the challenges of identifying relatively
rare entities amongst a healthy cohort. The imperfect diagnostic accuracy of all current
tests means that screening strategies have potential for harm through incorrect diagnoses
as well as the potential for identification of important sub-clinical pathologies.
Management of athletes at risk of ventricular arrhythmias and sudden cardiac death
is similarly complex. There is much yet to learn about the specific patterns of ventricular
arrhythmias in athletes, and the separation of benign from potentially life-threatening
remains imperfect. There are some promising advances, however, such as specialised
imaging modalities combined with improved electrophysiological diagnostics and therapeutics.
Some unique clinical patterns are emerging to advance our understanding and management
of athletes with ventricular arrhythmias, requiring specialised skillsets for evaluation
and management.
Keywords
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Article info
Publication history
Published online: October 13, 2018
Identification
Copyright
© 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
