Ventricular arrhythmias in athletes: Role of a comprehensive diagnostic workup
| Autor: | Luigi Di Biase, Alice Bonomi, Valentina Catto, Francesca Pizzamiglio, Antonio Dello Russo, Maria Antonietta Dessanai, Paolo Compagnucci, Alessio Gasperetti, Claudio Tondo, Cristina Basso, Cesare Fiorentini, Stefania Riva, Michela Casella, Alessandro Capucci, Paolo Zeppilli, Federico Guerra, Stefania Rizzo, Daniele Andreini, Andrea Natale, Gianluca Pontone, Giulia Stronati |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Adult
Male Electroanatomic mapping medicine.medical_specialty Myocarditis Abnormal echocardiogram Biopsy medicine.medical_treatment Catheter ablation Endomyocardial biopsy Electrophysiology study Ventricular arrhythmias Physiology (medical) Internal medicine Humans Medicine Late gadolinium enhancement Arrhythmogenic Right Ventricular Dysplasia Retrospective Studies medicine.diagnostic_test biology Athletes business.industry biology.organism_classification medicine.disease Confidence interval Arrhythmogenic right ventricular cardiomyopathy Tachycardia Ventricular Cardiology Female Electrophysiologic Techniques Cardiac Cardiology and Cardiovascular Medicine Cardiac magnetic resonance business |
| Popis: | Background Ventricular arrhythmias (VAs) represent a critical issue with regard to sports eligibility assessment in athletes. The ideal diagnostic evaluation of competitive and leisure-time athletes with complex VAs has not been clearly defined. Objective The purpose of this study was to assess the clinical implications of invasive electrophysiological assessments and endomyocardial biopsy (EMB) among athletes with VAs. Methods We evaluated 227 consecutive athletes who presented to our institutions after being disqualified from participating in sports because of VAs. After noninvasive tests, electrophysiological study (EPS), electroanatomic mapping (EAM), and EAM- or cardiac magnetic resonance imaging–guided EMB was performed, following a prespecified protocol. Sports eligibility status was redefined at 6-month follow-up. Results From our sample, 188 athletes (82.8%) underwent EAM and EPS, and 42 (15.2%) underwent EMB. A diagnosis of heart disease could be formulated in 30% of the study population (67/227; 95% confidence interval [CI] 0.24–0.36) after noninvasive tests; in 37% (83/227; 95% CI 31%–43%) after EPS and EAM; and in 45% (102/227; 95% CI 39%–51%) after EMB. In the subset of athletes undergoing EMB, invasive diagnostic workup allowed diagnostic reclassification of half of the athletes (n = 21 [50%]). Reclassification was particularly common among subjects without definitive findings after noninvasive evaluation (n = 23; 87% reclassified). History of syncope, abnormal echocardiogram, presence of late gadolinium enhancement, and abnormal EAM were linked to sports ineligibility at 6-month follow-up. Conclusion A comprehensive invasive workup provided additional diagnostic elements and could improve the sports eligibility assessment of athletes presenting with VAs. The extensive invasive evaluation presented could be especially helpful when noninvasive tests show unclear findings. |
| Databáze: | OpenAIRE |
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