Electrocardiographic findings during marathon running in healthy athletes using a new telemedical approach

Abstract

Objective: Despite the beneficial effects of regular endurance exercise on cardiovascular mortality and morbidity, complex ventricular arrhythmias and atrial fibrillation seem to be common in elite and amateur endurance athletes. Nevertheless, data on arrhythmias during endurance exercise is sparse. Our goal was to proof the feasibility for recording electrocardiogram (ECG) during marathon running, and to compare the first hour with the last hour of running. Methods: 11 healthy, male recreational athletes were equipped with a long-term Tele-ECG with continuous recording of the heart rhythm during running a marathon. All ECG data were directly transferred via mobile network from the device to the Telemedicine center (Campus, Berlin, Germany) for a subsequent online diagnosis (Streaming-Telemedtechnology) The recorded data was analyzed offline. Results: One runner had to be excluded due to artifact superimposed recording quality. Therefore 10 male runners were included in our study and completed a full or a half marathon. No episodes of atrial fibrillation could be detected. Two participants showed less than 10 ventricular premature beats (VPB) during running (Lown classification I). In another two athletes 15 polymorphic VPB (Lown classification IIIa) and 117 VPB (Lown classification IV b), including 8 couplets and one triplet were observed, respectively. There was no significant difference between the first and last hour of running concerning the number of ventricular premature beats (3.4±10.8 vs. 1.6±4.4, P = ns), mean heart rate (139.8±32.6 vs. 130.6±39.2 bpm, P = ns), maximal heart rate (150.0±32.3 vs. 149.4±37.1 bpm, P = ns), rate corrected QT-interval (444.3±35.7 vs. 439.2±25.2 ms, P = ns). Concerning heart rate variability (HRV), it remained unchanged during marathon running {HRV triangular index 11.2±9.9 vs. 10.9±8.5, P = ns; Standard deviation of all NN intervals (SDNN) 85.4±67.0 vs. 109.0±62.7 ms, P = ns}. Conclusion: We showed that ECG recording and immediate transmission of the signal by telemedicine during marathon running is feasible. In general, ventricular and supraventricular arrhythmias were rare during endurance sport in our athletes. In addition, there were no significant changes in ECG parameters during marathon running.