Prognostic evaluation of athletes affected by complex and frequent ventricular arrhythmias

SUMMARY The aim of this study was to clarify the prognostic value of ventricular arrhythmias (VA) in athletes. Methods. Three hundred and twenty competitive athletes with VA at baseline ECG (n = 307) or palpitations (n = 13), from a cohort of 19 367 subjects evaluated at our Center in the period 1984-2005, underwent clinical-instrumental screening including echocardiography and 24-h Holter ECG. The athletes were divided into three groups: group A (n = 166) with frequent (=2000/24 h) and/or complex ventricular premature beats (VPB) (couplets and/or triplets and/or non-sustained ventricular tachycardia); group B (n = 65) with VPB = 100 and = 2000/24 h; group C (n = 89) with VPB = 100/24 h. Follow-up for a mean of 8.5 ± 4.5 years was accomplished in all subjects and Holter ECG was performed in 157 of them. Results. At baseline examination, heart disease was absent in 260 athletes (81%) whereas it was detected in 18.1% of group A, 7.7% of group B and 28.1% of group C. During follow-up, one sudden death and one aborted sudden death occurred in group A. In the 157 athletes who underwent Holter ECG at follow-up, VA were found to be absent or less frequent in 54.6% of group A, 61.5% of group B and 69.5% of group C. Conclusions. Our study demonstrates that VA in athletes are usually not associated with heart disease and have a benign prognostic value.