Abstract
Cardiovascular modifications generated by high performance sports conform the athlete’s hear syndrome. These changes are manifested in the physical exam, electrocardiographic (at rest and with stress exercise) and echocardiographic studies and even in magnetic resonance imaging. (1, 2) Occasionally, the differentiation from diverse cardiac diseases is difficult and the decision to discharge or nor the athlete from sports activity can be complicated. (3) Although ending sports activities in a patient with certain cardiac diseases may protect him from a fatal event, unnecessary athlete disqualification is usually associated with psychosocial and economic problems which significantly alter quality of life. Severe sinus bradycardia (SB) and presence of prolonged ventricular pauses in Holter monitoring is one of the situations generating doubts in the conduct to follow in the asymptomatic athlete. When present, the athletes are occasionally discouraged to continue sports training, and even treatments, such as pacemaker implantation, may be suggested. The purpose of this presentation is to pose different cases with comments on the adopted decision. Four cases of asymptomatic high-performance athletes with prolonged ventricular pauses on Holter monitoring will be presented. Athletes had no structural heart disease (normal Doppler echocardiography and magnetic resonance imaging with and without gadolinium) and with adequate chronotropic response to exercise. A brief review and discussion will follow this presentation.
Published Version
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