Patterns of Ventricular Tachyarrhythmias Associated With Training, Deconditioning and Retraining in Elite Athletes Without Cardiovascular Abnormalities
Ventricular tachyarrhythmias commonly occur in trained athletes during ambulatory Holter electrocardiography and are usually associated with a benign course. Such arrhythmias have been demonstrated to be sensitive to short periods of athletic deconditioning; however, their response to retraining is...
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| Veröffentlicht in: | The American journal of cardiology 2011-03, Vol.107 (5), p.697-703 |
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| creator | Biffi, Alessandro, MD Maron, Barry J., MD Culasso, Franco, MD Verdile, Luisa, MD Fernando, Fredrick, MD Di Giacinto, Barbara, MD Di Paolo, Fernando M., MD Spataro, Antonio, MD Delise, Pietro, MD Pelliccia, Antonio, MD |
| description | Ventricular tachyarrhythmias commonly occur in trained athletes during ambulatory Holter electrocardiography and are usually associated with a benign course. Such arrhythmias have been demonstrated to be sensitive to short periods of athletic deconditioning; however, their response to retraining is not known. Twenty-four hour Holter electrocardiographic monitoring was performed at peak training and after 3 to 6 months of deconditioning and was repeated in the present study after 2, 6, and 12 months of retraining in 37 athletes with frequent and complex ventricular tachyarrhythmias and without cardiovascular abnormalities. These subjects showed partial (101 to 500 ventricular premature complexes [VPCs]/24 hours) or marked ( |
| doi_str_mv | 10.1016/j.amjcard.2010.10.049 |
| format | Article |
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Such arrhythmias have been demonstrated to be sensitive to short periods of athletic deconditioning; however, their response to retraining is not known. Twenty-four hour Holter electrocardiographic monitoring was performed at peak training and after 3 to 6 months of deconditioning and was repeated in the present study after 2, 6, and 12 months of retraining in 37 athletes with frequent and complex ventricular tachyarrhythmias and without cardiovascular abnormalities. These subjects showed partial (101 to 500 ventricular premature complexes [VPCs]/24 hours) or marked (<100 VPCs) reversibility of arrhythmias after deconditioning. Retraining initially resulted in a significant increase in arrhythmia frequency compared with deconditioning (from 280 ± 475 to 1,542 ± 2,186 VPCs; p = 0.005), couplets (0.14 ± 0.42 to 4.4 ± 8.2; p = 0.005), and nonsustained ventricular tachycardia (from 0 to 0.8 ± 1.8; p = 0.02). Subsequently, a progressive reduction was seen in the frequency of all ventricular arrhythmias during the 1 year of training to well below that at the peak training levels (VPCs 917 ± 1,630, couplets 1.8 ± 4.2, and nonsustained ventricular tachycardia 0.4 ± 1.2). Such annual arrhythmia reduction was significantly greater statistically in those athletes with marked reversibility after deconditioning than in the athletes with partial reversibility (69 ± 139 vs 1,496 ± 1,917 VPCs/24 hours, respectively; p = 0.007). No cardiac events or symptoms occurred during 1 year of follow-up. In conclusion, in elite athletes without cardiovascular disease, a resumption in intense training after deconditioning was associated with variable, but prolonged, suppression of ventricular ectopy. The absence of adverse clinical events or symptoms associated with the resumption of training supports the continued eligibility in competitive sports for such athletes and is also consistent with the benign nature of physiologic athlete's heart syndrome.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2010.10.049</identifier><identifier>PMID: 21316505</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Athletes ; Biological and medical sciences ; Cardiac arrhythmia ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular Abnormalities ; Cardiovascular Deconditioning ; Cardiovascular disease ; Disease Progression ; Electrocardiography, Ambulatory ; Female ; Follow-Up Studies ; Heart Rate - physiology ; Humans ; Incidence ; Italy - epidemiology ; Male ; Medical sciences ; Sports training ; Tachycardia, Ventricular - epidemiology ; Tachycardia, Ventricular - physiopathology ; Young Adult</subject><ispartof>The American journal of cardiology, 2011-03, Vol.107 (5), p.697-703</ispartof><rights>Elsevier Inc.</rights><rights>2011 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Sequoia S.A. Mar 1, 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-1b23126d1171d4ea125e9035bde5841a3c2374c6fe381783c62dd6c2686b55453</citedby><cites>FETCH-LOGICAL-c476t-1b23126d1171d4ea125e9035bde5841a3c2374c6fe381783c62dd6c2686b55453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.amjcard.2010.10.049$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23960441$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21316505$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Biffi, Alessandro, MD</creatorcontrib><creatorcontrib>Maron, Barry J., MD</creatorcontrib><creatorcontrib>Culasso, Franco, MD</creatorcontrib><creatorcontrib>Verdile, Luisa, MD</creatorcontrib><creatorcontrib>Fernando, Fredrick, MD</creatorcontrib><creatorcontrib>Di Giacinto, Barbara, MD</creatorcontrib><creatorcontrib>Di Paolo, Fernando M., MD</creatorcontrib><creatorcontrib>Spataro, Antonio, MD</creatorcontrib><creatorcontrib>Delise, Pietro, MD</creatorcontrib><creatorcontrib>Pelliccia, Antonio, MD</creatorcontrib><title>Patterns of Ventricular Tachyarrhythmias Associated With Training, Deconditioning and Retraining in Elite Athletes Without Cardiovascular Abnormalities</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Ventricular tachyarrhythmias commonly occur in trained athletes during ambulatory Holter electrocardiography and are usually associated with a benign course. Such arrhythmias have been demonstrated to be sensitive to short periods of athletic deconditioning; however, their response to retraining is not known. Twenty-four hour Holter electrocardiographic monitoring was performed at peak training and after 3 to 6 months of deconditioning and was repeated in the present study after 2, 6, and 12 months of retraining in 37 athletes with frequent and complex ventricular tachyarrhythmias and without cardiovascular abnormalities. These subjects showed partial (101 to 500 ventricular premature complexes [VPCs]/24 hours) or marked (<100 VPCs) reversibility of arrhythmias after deconditioning. Retraining initially resulted in a significant increase in arrhythmia frequency compared with deconditioning (from 280 ± 475 to 1,542 ± 2,186 VPCs; p = 0.005), couplets (0.14 ± 0.42 to 4.4 ± 8.2; p = 0.005), and nonsustained ventricular tachycardia (from 0 to 0.8 ± 1.8; p = 0.02). Subsequently, a progressive reduction was seen in the frequency of all ventricular arrhythmias during the 1 year of training to well below that at the peak training levels (VPCs 917 ± 1,630, couplets 1.8 ± 4.2, and nonsustained ventricular tachycardia 0.4 ± 1.2). Such annual arrhythmia reduction was significantly greater statistically in those athletes with marked reversibility after deconditioning than in the athletes with partial reversibility (69 ± 139 vs 1,496 ± 1,917 VPCs/24 hours, respectively; p = 0.007). No cardiac events or symptoms occurred during 1 year of follow-up. In conclusion, in elite athletes without cardiovascular disease, a resumption in intense training after deconditioning was associated with variable, but prolonged, suppression of ventricular ectopy. The absence of adverse clinical events or symptoms associated with the resumption of training supports the continued eligibility in competitive sports for such athletes and is also consistent with the benign nature of physiologic athlete's heart syndrome.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Athletes</subject><subject>Biological and medical sciences</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular Abnormalities</subject><subject>Cardiovascular Deconditioning</subject><subject>Cardiovascular disease</subject><subject>Disease Progression</subject><subject>Electrocardiography, Ambulatory</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Italy - epidemiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Sports training</subject><subject>Tachycardia, Ventricular - epidemiology</subject><subject>Tachycardia, Ventricular - physiopathology</subject><subject>Young Adult</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks1uEzEQx1cIREvhEUAWEuJCgsf2encvoCiUD6kSCAIcLceeEIddu9jeSnkSXhdvE4rUC6fRjH_z4flPVT0GOgcK8uVuroed0dHOGb2Ozano7lSn0DbdDDrgd6tTSimbdSC6k-pBSrviAtTyfnXCgIOsaX1a_f6kc8boEwkb8g19js6MvY5kpc12r2Pc7vN2cDqRRUrBOJ3Rku8ub8kqaued__GCvEETvHXZhckn2lvyGfPxmThPznuXkSzytseM6To9jJksy_QuXOl06LhY-xAHXViH6WF1b6P7hI-O9qz6-vZ8tXw_u_j47sNycTEzopF5BmvGgUkL0IAVqIHV2FFery3WrQDNDeONMHKDvIWm5UYya6VhspXruhY1P6ueH-pexvBrxJTV4JLBvtcew5hUW0Mjmq6byKe3yF0Yoy_DFajhgnPWFqg-QCaGlCJu1GV0g457BVRNuqmdOuqmJt2mcNGt5D05Fh_XA9qbrL9CFeDZESjr0v0mam9c-sfxTlIhoHCvDxyWpV05jCoZh96gdRFNVja4_47y6lYF0xclS9OfuMd082lQiSmqvkxHNt0YFMuEaPgfCo3POQ</recordid><startdate>20110301</startdate><enddate>20110301</enddate><creator>Biffi, Alessandro, MD</creator><creator>Maron, Barry J., MD</creator><creator>Culasso, Franco, MD</creator><creator>Verdile, Luisa, MD</creator><creator>Fernando, Fredrick, MD</creator><creator>Di Giacinto, Barbara, MD</creator><creator>Di Paolo, Fernando M., MD</creator><creator>Spataro, Antonio, MD</creator><creator>Delise, Pietro, MD</creator><creator>Pelliccia, Antonio, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20110301</creationdate><title>Patterns of Ventricular Tachyarrhythmias Associated With Training, Deconditioning and Retraining in Elite Athletes Without Cardiovascular Abnormalities</title><author>Biffi, Alessandro, MD ; Maron, Barry J., MD ; Culasso, Franco, MD ; Verdile, Luisa, MD ; Fernando, Fredrick, MD ; Di Giacinto, Barbara, MD ; Di Paolo, Fernando M., MD ; Spataro, Antonio, MD ; Delise, Pietro, MD ; Pelliccia, Antonio, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-1b23126d1171d4ea125e9035bde5841a3c2374c6fe381783c62dd6c2686b55453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Athletes</topic><topic>Biological and medical sciences</topic><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular Abnormalities</topic><topic>Cardiovascular Deconditioning</topic><topic>Cardiovascular disease</topic><topic>Disease Progression</topic><topic>Electrocardiography, Ambulatory</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Italy - epidemiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Sports training</topic><topic>Tachycardia, Ventricular - epidemiology</topic><topic>Tachycardia, Ventricular - physiopathology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Biffi, Alessandro, MD</creatorcontrib><creatorcontrib>Maron, Barry J., MD</creatorcontrib><creatorcontrib>Culasso, Franco, MD</creatorcontrib><creatorcontrib>Verdile, Luisa, MD</creatorcontrib><creatorcontrib>Fernando, Fredrick, MD</creatorcontrib><creatorcontrib>Di Giacinto, Barbara, MD</creatorcontrib><creatorcontrib>Di Paolo, Fernando M., MD</creatorcontrib><creatorcontrib>Spataro, Antonio, MD</creatorcontrib><creatorcontrib>Delise, Pietro, MD</creatorcontrib><creatorcontrib>Pelliccia, Antonio, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Biffi, Alessandro, MD</au><au>Maron, Barry J., MD</au><au>Culasso, Franco, MD</au><au>Verdile, Luisa, MD</au><au>Fernando, Fredrick, MD</au><au>Di Giacinto, Barbara, MD</au><au>Di Paolo, Fernando M., MD</au><au>Spataro, Antonio, MD</au><au>Delise, Pietro, MD</au><au>Pelliccia, Antonio, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patterns of Ventricular Tachyarrhythmias Associated With Training, Deconditioning and Retraining in Elite Athletes Without Cardiovascular Abnormalities</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2011-03-01</date><risdate>2011</risdate><volume>107</volume><issue>5</issue><spage>697</spage><epage>703</epage><pages>697-703</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Ventricular tachyarrhythmias commonly occur in trained athletes during ambulatory Holter electrocardiography and are usually associated with a benign course. Such arrhythmias have been demonstrated to be sensitive to short periods of athletic deconditioning; however, their response to retraining is not known. Twenty-four hour Holter electrocardiographic monitoring was performed at peak training and after 3 to 6 months of deconditioning and was repeated in the present study after 2, 6, and 12 months of retraining in 37 athletes with frequent and complex ventricular tachyarrhythmias and without cardiovascular abnormalities. These subjects showed partial (101 to 500 ventricular premature complexes [VPCs]/24 hours) or marked (<100 VPCs) reversibility of arrhythmias after deconditioning. Retraining initially resulted in a significant increase in arrhythmia frequency compared with deconditioning (from 280 ± 475 to 1,542 ± 2,186 VPCs; p = 0.005), couplets (0.14 ± 0.42 to 4.4 ± 8.2; p = 0.005), and nonsustained ventricular tachycardia (from 0 to 0.8 ± 1.8; p = 0.02). Subsequently, a progressive reduction was seen in the frequency of all ventricular arrhythmias during the 1 year of training to well below that at the peak training levels (VPCs 917 ± 1,630, couplets 1.8 ± 4.2, and nonsustained ventricular tachycardia 0.4 ± 1.2). Such annual arrhythmia reduction was significantly greater statistically in those athletes with marked reversibility after deconditioning than in the athletes with partial reversibility (69 ± 139 vs 1,496 ± 1,917 VPCs/24 hours, respectively; p = 0.007). No cardiac events or symptoms occurred during 1 year of follow-up. In conclusion, in elite athletes without cardiovascular disease, a resumption in intense training after deconditioning was associated with variable, but prolonged, suppression of ventricular ectopy. The absence of adverse clinical events or symptoms associated with the resumption of training supports the continued eligibility in competitive sports for such athletes and is also consistent with the benign nature of physiologic athlete's heart syndrome.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21316505</pmid><doi>10.1016/j.amjcard.2010.10.049</doi><tpages>7</tpages></addata></record> |
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| subjects | Adolescent Adult Athletes Biological and medical sciences Cardiac arrhythmia Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular Abnormalities Cardiovascular Deconditioning Cardiovascular disease Disease Progression Electrocardiography, Ambulatory Female Follow-Up Studies Heart Rate - physiology Humans Incidence Italy - epidemiology Male Medical sciences Sports training Tachycardia, Ventricular - epidemiology Tachycardia, Ventricular - physiopathology Young Adult |
| title | Patterns of Ventricular Tachyarrhythmias Associated With Training, Deconditioning and Retraining in Elite Athletes Without Cardiovascular Abnormalities |
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