Prognostic Evaluation of Ventricular Arrhythmias in Athletes

Abstract

Ventricular arrhythmias (VA) can occur in a variety of heart diseases as well as in normal persons. Although the normal range of the VA is still under debate, there is general agreement that frequent and or complex VA are an uncommon finding in normal subjects without any apparent structural heart disease. Therefore, some degree of VA very likely represents a marker of a pathological condition requiring accurate diagnostic assessment to determine the real impact of the VA in the clinical setting and its preventive and/or therapeutic implications. Generally, the normal range of VA varies from 10 to 100 ventricular premature ectopic beats (VPB) / 24 hour, whereas the complex forms (couplets, multiplets and non-sustained ventricular tachycardia) are usually absent in normal subjects. Non-sustained ventricular tachycardia (N,SVT) of more than 10-15 beats, with a rate >150 min., as well as sustained monomorphic or polymorphic ventricular tachycardia (SVT) should also be considered as malignant forms in healthy subjects without evident cardiovascular abnormalities. In fact, idiopathic ventricular tachyarrhythmia is not particularly rare cause of sudden cardiac death, ranging in the literature from 1% to 14% of patients less than 40 years old who have survived an episode of sudden unexpected cardiac arrest [1,2].