Arrhythmias & electrophysiology
Long-Term Risk Assessment in Athletes With Complex Ventricular Arrhythmias
Authors' conclusion
A comprehensive diagnostic assessment integrating ECG, stress testing, and imaging findings, along with the selective use of invasive electrophysiology assessments, may help refine the prognostic evaluation of athletes with complex VAs.
Study context
- Population
- Athletes with frequent or exercise-induced premature ventricular complexes or nonsustained ventricular tachycardiaathletes, 148 [78%] competitive athletes
- Participants
- One-hundred-ninety participants
- Exposure
- Common vs uncommon
- Commonn = 99
- Uncommonn = 91
- Outcome
- Sudden death or sustained VAs
- Follow-up
- Median 6.2 (4.3-8.1) years
Main finding
As reported in the abstract
Athletes experienced a primary outcome event, including 1 sudden death
7
4%
Observational data: associations, not effects.
Further findings
Abnormal findings at multimodality assessment and final diagnoses of structural heart disease
- Higher with uncommon VA morphology
Factors associated with the primary end point (univariable Cox models)
- Uncommon VA morphology
- P = 0.003
- Lack of VA suppression during stress testing
- P = 0.049
- Nonsustained ventricular tachycardia/ventricular tachycardia induction during stress testing
- P = 0.010
- Late gadolinium enhancement
- P = 0.045
- Electroanatomical scar regions
- P = 0.022
- Sustained VA inducibility by electrophysiology study
- P < 0.001
Incremental prediction of invasive tests over clinical/noninvasive findings
- Log-likelihood ratio for nested models
- P = 0.004
Survival tree model risk stratification
- Identifying subgroups of athletes without primary outcome events during follow-up
Return to competition among 148 competitive athletes
- Regained eligibility after 3 months of detraining, of 148 competitive athletes
- 101 (68%)
- Continued long-term, of 148 competitive athletes
- 42 (28%)
Original publication
Summarised from the published abstract; every number is checked against it