Ventricular late potentials measured by signal-averaged electrocardiogram in young professional soccer players
Open Access
- 26 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in International Journal of Arrhythmia
- Vol. 22 (1), 1-8
- https://doi.org/10.1186/s42444-021-00031-1
Abstract
Background and objectives: Athlete’s heart is characterized by structural cardiac changes, including enlargement and hypertrophy. However, exercise-induced cardiac electrical remodeling is not well known in Asian athletes. We sought to evaluate the association between vigorous exercise and the development of abnormal late potential on signal-averaged electrocardiogram (SAECG). Method: We analyzed 48 Korean professional soccer players and 71 healthy sedentary controls who underwent SAECG and transthoracic echocardiography at Kyung Hee University Hospital. An SAECG was considered abnormal (positive for ventricular late potential) when any one of the three following criteria was met: filtered QRS duration > 114 ms, root-mean-square voltage in the terminal 40 ms < 20 uV, or a voltage < 40 uV for more than 38 ms. Results: Fragmented QRS was more commonly found in athletes (1.4% vs. 10.4%). Athletes demonstrated significantly higher proportion of filtered QRS duration > 114 ms (7.0% vs. 22.9%, P = 0.013) and lower terminal QRS root-mean-square voltage < 20 uV (5.6% vs. 20.8%, P = 0.012). Ventricular late potential on SAECG was significantly more frequent in athletes (15.5% vs. 35.4%, P = 0.012). Regarding echocardiographic parameters, the athletes had larger cardiac chamber size; however, these differences became non-significant after adjustment for body surface area, except left ventricular mass index (65.7 ± 12.7 g/m2 vs. 84.7 ± 17.7 g/m2, P < 0.001). Conclusion: Abnormal SAECG findings were significantly more common in athletes than in controls. Further study is needed to determine the clinical impact of these abnormal SAECGs in athletes and cardiac outcomes in the long term.Keywords
Funding Information
- Korean Heart Rhythm Society (KHRS 2016-5)
This publication has 29 references indexed in Scilit:
- Outcomes of Cardiac Screening in Adolescent Soccer PlayersThe New England Journal of Medicine, 2018
- European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) joint position statement: recommendations for the indication and interpretation of cardiovascular imaging in the evaluation of the athlete's heartEuropean Heart Journal, 2018
- Signal‐averaged electrocardiography: Past, present, and futureJournal of Arrhythmia, 2018
- Leisure Time Physical Activity and Mortality A Detailed Pooled Analysis of the Dose-Response RelationshipJAMA Internal Medicine, 2015
- Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort studyThe Lancet, 2011
- Position statement on physical activity and exercise intensity terminologyJournal of Science and Medicine in Sport, 2010
- Diagnosis of Arrhythmogenic Right Ventricular Cardiomyopathy/DysplasiaCirculation, 2010
- Prediction of Long-Term Outcomes by Signal-Averaged Electrocardiography in Patients With Unsustained Ventricular Tachycardia, Coronary Artery Disease, and Left Ventricular DysfunctionCirculation, 2001
- Triggering of Sudden Death from Cardiac Causes by Vigorous ExertionThe New England Journal of Medicine, 2000
- Risk stratification for arrhythmic events in postinfarction patients based on heart rate variability, ambulatory electrocardiographic variables and the signal-averaged electrocardiogramJournal of the American College of Cardiology, 1991