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Review
How to evaluate premature ventricular beats in the athlete: critical review and proposal of a diagnostic algorithm
  1. Domenico Corrado1,
  2. Jonathan A Drezner2,
  3. Flavio D'Ascenzi3,
  4. Alessandro Zorzi1
  1. 1 Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
  2. 2 Stadium Sports Medicine Center, University of Washington, Seattle, Washington, USA
  3. 3 Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
  1. Correspondence to Professor Domenico Corrado, Department of Cardiac, Thoracic, Vascular and Public Health sciences, University of Padova, Via Giustiniani 2, 35128, Padova, Italy; domenico.corrado{at}unipd.it

Abstract

Although premature ventricular beats (PVBs) in young people and athletes are usually benign, they may rarely mark underlying heart disease and risk of sudden cardiac death during sport. This review addresses the prevalence, clinical meaning and diagnostic/prognostic assessment of PVBs in the athlete. The article focuses on the characteristics of PVBs, such as the morphological pattern of the ectopic QRS and the response to exercise, which accurately stratify risk. We propose an algorithm to help the sport and exercise physician manage the athlete with PVBs. We also address (1) which athletes need more indepth investigation, including cardiac MRI to exclude an underlying pathological myocardial substrate, and (2) which athletes can remain eligible to competitive sports and who needs to be excluded.

  • athlete’s heart
  • sudden cardiac death
  • arrhythmias
  • ectopic beats
  • premature ventricular contraction
  • eligibility
  • disqualification
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bjsports-2018-100529

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    Footnotes

    • Contributors All authors contributed to writing and reviewing the manuscript.

    • Funding Supported by BIRD (Budget for Integrated Department Research Project) 2016–2018, University of Padova, Italy.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.