Holter Ecg In Sports People

Abstract

PURPOSE: Arrhythmias are a common finding in the population that practices sports activity and sometimes their clinical interpretation is not easy. Thus, we aimed to analyze and follow up the recordings in a group of subjects who underwent a 24-hour or weekly Holter ECG monitoring to assess the presence of arrhythmias in a large cohort of sportsmen. METHODS: Since April 1997 to April 2017, 6172 unselected and consecutive subjects (35±22 years) were enrolled. Revision analysis was performed by Holter Analysis System (Spacelabs Healthcare, LLC, California) on a sample of 10903 Holter ECG registrations, focusing on the ECG features, such as arrhythmias (origin, number, complexity), conduction delays and channellopathies. We then divided the population with follow ups by sex and into three age groups to follow the trend of arrhythmias (age<18; age=18- 35; age>35). RESULTS: The subjects were 68,6% male and 31,4% female. The 27,8% of them (n=1716) had a semiannual or yearly Holter ECG follow-up, composing the 58,7% of the total amount of recordings. AV blocks were found 13,1% recordings (mainly AVB I and II-degree type 1) and other blocks in the 3,2%. Ventricular pre-excitation was recorded in 3,2% cases, whereas channellopathies in the 0,4% (BS or LQTS). Supraventricular arrhythmia was found in the 80% of recordings (<100 ectopic beats in 24h=76,0%), while ventricular arrhythmia in the 69,3% of exams (<100 ectopic beats in 24h=62,3%). CONCLUSIONS: In the Holter recordings examined, we found that there was a clear prevalence of arrhythmias (91,4%) compared to conduction delays (16,3%) and channellopathies (0,4%). Analyzing in detail the features of the arrhythmias we observed that the 41,5% of the population of the study had more than 100 ectopic beats/24h and more than one fourth of the subjects had complex supraventricular (28,0%) or ventricular (23,9%) arrhythmias. Analyzing the follow ups, we found that older athletes had higher complexity and prevalence of arrhythmias, whereas younger people had higher frequency of arrhythmias in the 24h recordings. Arrhythmic peaks in each of the three age groups were found respectively at 14±2 years, 24±4,5 years and 58±11,1 yrs. These findings lead us to say that in sports population arrhythmias are a common event and they are often compatible with sports practice.