Burden of ventricular arrhythmias at 12-lead 24-hour ambulatory ECG monitoring in middle-aged endurance athletes versus sedentary controls
Burden of ventricular arrhythmias at 12-lead 24-hour ambulatory ECG monitoring in middle-aged endurance athletes versus sedentary controls
复制标题
中年耐力运动员与久坐对照者 12 导联 24 小时动态心电图监测的室性心律失常负担
DOI：
10.1177/2047487318797396
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发表时间：
2018
影响因子：
8.3
通讯作者：
D. Corrado
中科院分区：
文献类型：
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作者：
A. Zorzi;G. Mastella;A. Cipriani;G. Berton;A. Del Monte;Beatrice Gusella;A. Nese;L. Portolan;F. Sciacca;S. Tikvina;S. Tollot;D. Trovato;S. Iliceto;M. Schiavon;D. Corrado
长期剧烈运动是否会增加中年运动员室性心律失常的发生率仍有待确定。设计前瞻性、病例对照。方法对134名30岁以上的健康竞技运动员（中位年龄45（39-51）岁，83%为男性）进行连续13 ± 4年每周9 ± 2 h的耐力性运动（跑步、自行车、铁人三项）训练。134名年龄和性别匹配的个体作为对照。两组均接受12导联24小时动态心电图监测，其中包括运动员的训练课程。从数量、复杂性（即成对、三重或非持续性室性心动过速）、运动诱发性和形态学方面评估室性心律失常。结果35名（26%）运动员和31名（23%）对照组显示>10次孤立性室性早搏或≥1次复杂性室性心律失常（p = 0.53）。有室性心律失常的运动员年龄较大（中位数48岁对43岁，p = 0.03），但与无室性心律失常的运动员相比，在训练时间和活动年数方面没有差异。10名（7%）运动员和6名（5%）对照组显示>500次室性早搏/24 h（p = 0.30）：最常见的室性心律失常形态为漏斗型（6名运动员和5名对照组）和分支型（2名运动员和1名对照组）。结论：中年运动员和久坐对照组24小时动态心电图室性心律失常的患病率无差异，且与运动量和持续时间无关。这些发现不支持耐力运动增加室性心律失常负担的假设。在频繁室性早搏的个体中，主要的异位QRS形态与心律失常的特发性和良性性质一致。
Background Whether prolonged and intense exercise increases the incidence of ventricular arrhythmias in middle-aged athletes remains to be established. Design Prospective, case-control. Methods We studied 134 healthy competitive athletes >30 years old (median age 45 (39–51) years, 83% males) who had been engaged in 9 ± 2 h per week of endurance sports activity (running, cycling, triathlon) for 13 ± 4 consecutive years. One hundred and thirty-four age- and gender-matched individuals served as controls. Both groups underwent 12-lead 24-h ambulatory electrocardiogram monitoring, which included a training session in athletes. Ventricular arrhythmias were evaluated in terms of number, complexity (i.e. couplet, triplet or non-sustained ventricular tachycardia), exercise-inducibility and morphology. Results Thirty-five (26%) athletes and 31 (23%) controls showed >10 isolated premature ventricular beats or ≥1 complex ventricular arrhythmia (p = 0.53). Athletes with ventricular arrhythmias were older (median 48 versus 43 years old, p = 0.03) but did not differ with regard to hours of training and years of activity compared with athletes without ventricular arrhythmias. Ten (7%) athletes and six (5%) controls showed >500 premature ventricular beats/24 h (p = 0.30): the most common ventricular arrhythmia morphologies were infundibular (six athletes and five controls) and fascicular (two athletes and one control). Conclusions The prevalence of ventricular arrhythmias at 24-hour ambulatory electrocardiogram monitoring did not differ between middle-aged athletes and sedentary controls and was unrelated to the amount and duration of exercise. These findings do not support the hypothesis that endurance sports activity increases the burden of ventricular arrhythmias. Among individuals with frequent premature ventricular beats, the predominant ectopic QRS morphologies were consistent with the idiopathic and benign nature of the arrhythmia.