Table 3

Classification and risk stratification of premature ventricular beats in the athlete

PVB characteristics
Ectopic QRS morphologyLBBB/inferior axis, typical RBBB and narrow QRS (<130 ms)LBBB/intermediate or superior axis, atypical RBBB and wide QRS (≥130 ms)
Response to exercise testingDecrease/suppressionPersistence/increase
Complexity of PVBsIsolated, monomorphicRepetitive‡, polymorphic
Short coupling interval*NoYes
Clinical findings
Family history of premature SCD† or cardiomyopathyNoYes
Other ECG abnormalitiesNoYes
Imaging abnormalitiesNoYes
  • *PVBs are superimposed on the preceding T-wave peak or earlier (ie, R on T).

  • †Premature sudden cardiac death (SCD) is defined as that occurring before 40 years of age in men and before 50 years old in women.

  • ‡Couplets, triplets or non-sustained ventricular tachycardia.

  • LBBB, left bundle branch block; PVBs, premature ventricular beats; RBBB, right bundle branch block.