Cardiac conduction disorders in athletes: diagnosis and management

##plugins.themes.academic_pro.article.sidebar##

Published May 6, 2011
Download
pdf
Vol. 89 No. 5 (2011): Issue May 2011

##plugins.themes.academic_pro.article.main##

Sonia Ammar
Zahreddine Smiri
Abdeddayem Haggui
Nadia Barakett
Wafa Fehri
Habib Haouala

Abstract

Background: The sino-atrial or atrio-ventricular conduction disturbances are commonly seen in athletes. They are due to predominant effect of the parasympathetic tone.
Aim: To describe the physiological cardiac adaptation to physical exercises and to specify the limits of this activity in front of persons with conduction abnormalities.
Methods: Review of literature and lecture of recommendations.
Results: conduction disturbances in athletes disappear during physical activities. Their frequency is variously reported in literature.
These disorders should be well considered particularly when they are priors to sport practice and need definitive implantable devices. Such decision must be taken after a detailed evaluation of the nature of the physical activity wished and the conduction disturbance type.
Conclusion: The decision to allow competition should be take after a careful evaluation of the conduction disorder and the type of sport.

Keywords:

Heart, Sport, Conduction disorder, Electrodiagnosis

##plugins.themes.academic_pro.article.details##

References

  1. Maron BJ. Structural features of the athlete's heart as defined by echocardiography. J Am Coll Cardiol 1986; 7: 190-203.
  2. Pelliccia A, Maron BJ, Spataro A, Proschan MA, Spirito P. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. N Engl J Med 1991; 324:295-301.
  3. Mitchell JH, Raven PB. Cardiovascular adaptation to physical activity. In: Bouchard C, Shephard R, Stephen T, editors. Physical Activity, Fitness, and Health: International Proceedings and Consensus Statement.
  4. Olgin JE, Zipes DP. Specific arrhythmias: diagnosis and treatment. In: Zipes DP, Libby P, Bonow RO, Braunwald E, editors. Heart Disease: A Textbook of Cardiovascular Medicine. Philadelphia, PA: Saunders, 2005: 803- 63.
  5. Cousteau JP. The heart of athletes in intensive competition. Rev Prat. 1981; 31: 1811-2, 1815-6, 1819-20.
  6. Cousteau JP. Le coeur d'athlète. In : Cardiologie sportive. Paris : Masson, 1988 : 28-42.
  7. Potiron-Josse M. Cardiologic problems seen in sports medicine. Soins Cardiol 1985; 27: 15-8.
  8. Viitasalo MT, Kala R, Eisalo A. Ambulatory electrocardiographic findings in young athletes between 14 and 16 years of age. Eur Heart J. 1984; 5: 2-6.
  9. Zipes D, Ackerman MJ, Estes M, Grant AO, Myerburg RJ, Van Hare G. Task Force 7: Arrhythmias. JACC 2005; 8 : 1354-63.
  10. Gregoratos G, Abrams J, Epstein AE et al. ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committee to Update the 1998 Pacemaker Guidelines).Circulation 2002; 106: 2145-61.
  11. B.J. Maron and J.H. Mitchell, 26th Bethesda Conference: recommendations for determining eligibility for competition in athletes with cardiovascular abnormalities. J Am Coll Cardiol 1994; 24: 845-99.
  12. B.J. Maron, R.W. Brown, C.A. McGrew, M.J. Mitten, A.L. Caplan, A.M. Hutter Jr. Ethical, legal, and practical considerations affecting medical decision-making in competitive athletes, J Am Coll Cardiol 1994; 24: 854-60.
  13. Mitchell JH, Haskell W, Snell P, Van Camp SP. Task Force 8: Classification of Sports .JACC 2005; 45: 1364-7.
  14. Graham TP Jr, Driscoll DJ, Gersony WM, Newburger JW, Rocchini A, Towbin JA. Task Force 2: congenital heart disease. J Am Coll Cardiol 2005; 45: 1326-33.
  15. Estes NA, Cannom D, Naccarelli GV, Prystowsky EN, Maron BJ, Olshansky B. Expert Consensus Conference on Arrhythmias in the Athlete of the North American Society of Pacing and Electrophysiololgy. NASPE Policy Conference on Arrhythmias and the Athlete. J. Cardiovasc. Electrophysiol 2001; 12: 1208-19.
  16. Mayosi BM, Little F, Millar RN. Long-term survival after permanent pacemaker implantation in young adults: 30 years experience. Pacing Clin Electro physiol 1999; 22: 407-412.
  17. Clémenty J, Vancollie O, Garrigue S, et al. De quels moyens disposons-nous pour évaluer la qualité de la vie des patients porteurs d'un stimulateur cardiaque? Ann Cardiol Angeiol 2000 ; 49 : 245-51.
  18. Sudkamp M, Menzel C, Sindhu D et al. Is measuring by portable heart rate monitors (sport watches) dependable in patients with an implanted pacemaker. Dtsch Med Wochenschr 2005; 130: 1307-10.