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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.

Competing Interests: Competing interests: None declared.

Titel:	How to evaluate premature ventricular beats in the athlete: critical review and proposal of a diagnostic algorithm.
Autor/in / Beteiligte Person:	Corrado, D ; Drezner, JA ; D'Ascenzi, F ; Zorzi, A
Zeitschrift:	British journal of sports medicine, Jg. 54 (2020-10-01), Heft 19, S. 1142-1148
Veröffentlichung:	London : BMJ Publishing Group ; <i>Original Publication</i>: Loughborough, Eng., 2020
Medientyp:	academicJournal
ISSN:	1473-0480 (electronic)
DOI:	10.1136/bjsports-2018-100529
Schlagwort:	Clinical Decision-Making Competitive Behavior physiology Diagnosis, Differential Echocardiography Electrocardiography Exercise physiology Exercise Test Humans Magnetic Resonance Imaging Physical Conditioning, Human physiology Prevalence Prognosis Ventricular Premature Complexes epidemiology Ventricular Premature Complexes pathology Ventricular Premature Complexes physiopathology Algorithms Risk Assessment methods Sports Ventricular Premature Complexes diagnosis
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Review Language: English [Br J Sports Med] 2020 Oct; Vol. 54 (19), pp. 1142-1148. <i>Date of Electronic Publication: </i>2019 Sep 03. MeSH Terms: Algorithms* ; Sports* ; Risk Assessment / methods ; Ventricular Premature Complexes / diagnosis ; Clinical Decision-Making ; Competitive Behavior / physiology ; Diagnosis, Differential ; Echocardiography ; Electrocardiography ; Exercise / physiology ; Exercise Test ; Humans ; Magnetic Resonance Imaging ; Physical Conditioning, Human / physiology ; Prevalence ; Prognosis ; Ventricular Premature Complexes / epidemiology ; Ventricular Premature Complexes / pathology ; Ventricular Premature Complexes / physiopathology References: J Am Coll Cardiol. 2001 Aug;38(2):364-70. (PMID: 11499725) ; Circ Arrhythm Electrophysiol. 2015 Jun;8(3):616-24. (PMID: 25925230) ; Eur J Prev Cardiol. 2018 Dec;25(18):2003-2011. (PMID: 30160531) ; Br Heart J. 1982 Mar;47(3):213-20. (PMID: 7059398) ; Am Heart J. 1985 Sep;110(3):560-7. (PMID: 2412427) ; Eur J Cardiovasc Prev Rehabil. 2006 Oct;13(5):676-86. (PMID: 17001205) ; Circulation. 1994 Mar;89(3):1174-82. (PMID: 8124804) ; J Cardiol. 2016 Dec;68(6):463-471. (PMID: 27401396) ; Heart Rhythm. 2019 Feb;16(2):239-248. (PMID: 30172028) ; Circulation. 2010 Apr 6;121(13):1533-41. (PMID: 20172911) ; Card Electrophysiol Clin. 2016 Sep;8(3):545-54. (PMID: 27521088) ; J Am Coll Cardiol. 2004 Sep 1;44(5):1053-8. (PMID: 15337218) ; Circ Res. 2017 Sep 15;121(7):784-802. (PMID: 28912183) ; Card Electrophysiol Clin. 2016 Sep;8(3):503-14. (PMID: 27521085) ; Br J Sports Med. 2017 May;51(9):704-731. (PMID: 28258178) ; J Am Heart Assoc. 2018 Jun 9;7(12):. (PMID: 29886418) ; J Clin Pharmacol. 2016 Jul;56(7):885-93. (PMID: 26626443) ; Circ Arrhythm Electrophysiol. 2014 Jun;7(3):456-62. (PMID: 24771543) ; Chest. 1998 Jul;114(1):89-93. (PMID: 9674452) ; Int J Cardiol. 2015 Feb 1;180:142-4. (PMID: 25438235) ; Heart Rhythm. 2015 Jan;12(1):78-85. (PMID: 25239428) ; Eur Heart J. 2009 Nov;30(21):2599-605. (PMID: 19689975) ; Eur Heart J. 2007 Oct;28(19):2338-45. (PMID: 17656346) ; Circulation. 2015 Dec 1;132(22):e315-25. (PMID: 26621650) ; Heart. 2004 Jun;90(6):645-9. (PMID: 15145868) ; Am J Cardiol. 1982 Jul;50(1):23-31. (PMID: 6124117) ; Circulation. 2006 Oct 10;114(15):1633-44. (PMID: 17030703) ; Am J Cardiol. 2008 Jun 15;101(12):1792-5. (PMID: 18549861) ; Int J Cardiovasc Imaging. 2010 Aug;26(6):701-10. (PMID: 20339919) ; J Am Coll Cardiol. 2008 Dec 16;52(25):2175-87. (PMID: 19095136) ; N Engl J Med. 2017 Jan 5;376(1):61-72. (PMID: 28052233) ; Eur Heart J. 2003 Aug;24(16):1473-80. (PMID: 12919770) ; Eur Heart J. 1984 Jan;5(1):2-6. (PMID: 6705801) ; Am J Cardiol. 2013 Nov 1;112(9):1396-402. (PMID: 24135302) ; BMJ. 2008 Jul 03;337:a346. (PMID: 18599474) ; Am J Cardiol. 2013 Feb 15;111(4):557-62. (PMID: 23219000) ; Circ Arrhythm Electrophysiol. 2016 Jul;9(7):. (PMID: 27390211) ; J Am Coll Cardiol. 2003 Dec 3;42(11):1959-63. (PMID: 14662259) ; N Engl J Med. 1985 Jan 24;312(4):193-7. (PMID: 2578212) ; Ann Noninvasive Electrocardiol. 2007 Apr;12(2):121-9. (PMID: 17593180) ; Heart Rhythm. 2016 Oct;13(10):e295-324. (PMID: 27423412) ; Curr Cardiol Rep. 2016 Jun;18(6):57. (PMID: 27147509) ; Circulation. 2004 May 25;109(20):2374-5. (PMID: 15159325) ; Heart. 2017 May;103(9):702-707. (PMID: 27798051) ; Am J Cardiol. 1993 Oct 15;72(12):978-9. (PMID: 8213561) ; Am J Cardiol. 1983 Oct 1;52(7):859-61. (PMID: 6624677) ; Chest. 1982 Jul;82(1):19-24. (PMID: 7083929) ; Eur J Prev Cardiol. 2017 Jan;24(1):41-69. (PMID: 27815537) ; Circulation. 2015 Aug 18;132(7):556-66. (PMID: 26160859) ; Cardiology. 1994;84(1):42-50. (PMID: 8149388) ; J Am Coll Cardiol. 2002 Aug 7;40(3):446-52. (PMID: 12142109) ; Circulation. 2002 Jul 2;106(1):69-74. (PMID: 12093772) ; Br J Sports Med. 2016 Jan;50(2):111-7. (PMID: 26224114) ; Heart. 2009 Aug;95(15):1230-7. (PMID: 19429571) ; Eur Heart J. 2010 Jan;31(2):243-59. (PMID: 19933514) ; Card Electrophysiol Clin. 2016 Sep;8(3):567-80. (PMID: 27521090) ; N Engl J Med. 1998 Aug 6;339(6):364-9. (PMID: 9691102) ; Europace. 2017 Apr 1;19(4):622-628. (PMID: 28431055) ; Circulation. 2004 May 25;109(20):2417-22. (PMID: 15148273) ; Am J Cardiol. 2011 Mar 1;107(5):697-703. (PMID: 21316505) ; J Cardiovasc Med (Hagerstown). 2011 Mar;12(3):157-61. (PMID: 21139509) Contributed Indexing: Keywords: arrhythmias; athlete’s heart; disqualification; ectopic beats; eligibility; premature ventricular contraction; sudden cardiac death Entry Date(s): Date Created: 20190905 Date Completed: 20201015 Latest Revision: 20201015 Update Code: 20240513 PubMed Central ID: PMC7513269

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How to evaluate premature ventricular beats in the athlete: critical review and proposal of a diagnostic algorithm.