UTILITY OF ITALIAN CARDIOLOGIC SCREENING IN TOP-LEVEL ATHLETES WITH WOLFF-PARKINSON-WHITE 640

Abstract

From February 1991 to December 1995 80 athletes with Wolff-Parkinson White(WPW)undrwent a complete cardiologic screening as mandatory by italian low for sport practice. The screening included a clinical examination, blood test exams, chest X-rays, resting and stress-test electrocardiogram, Color-Doppler echo-cardiogram and transesophageal pacing at rest and during exercise. 65% of athletes were asymptomatic and 35% symptomatic for palpitations. In 75% of cases ventricular preexcitation disappeared during exercise. In only 2.2% stress-test ECG and 24-hour Holter monitoring showed the presence of cardiac arrhythmias (atrial fibrillation). In 60% of athletes transesophageal pacing induced or reproduced the clinical arrhythmia (83.3% atrial fibrillation or flutter, 16.7% reciprocating orthodromic tachycardia). In 91.6% of athletes the arrhythmias were induced during exercise or both during exercise and at rest. In only 8.4% the arrhythmias were induced at rest. In 100% of symptomatic athletes transesophageal pacing induced an arrhythmia in regard to 38.5% of asymtomatic. Despite of the great inducibility of arrhythmias, 74% of athletes were considered elegible and 26% were stopped, according to the italian cardiological protocols.