• Alessandro Zorzi, Manuel De Lazzari, Giulio Mastella, Alice Niero, Domenico Trovato, Alberto Cipriani, Francesco Peruzza, Leonardo Portolan, Giampaolo Berton, Federco Sciacca, Saverio Tollot, Chiara Palermo, Roberto Bellu, Flavio D'ascenzi, Denisa Muraru, Luigi Paolo Badano, Sabino Iliceto, Maurizio Schiavon, Martina Perazzolo Marra, and Domenico Corrado.
• Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy.
• J Am Heart Assoc. 2018 Jun 9; 7 (12).

BackgroundWhether ventricular arrhythmias (VAs) represent a feature of the adaptive changes of the athlete's heart remains elusive. We aimed to assess the prevalence, determinants, and underlying substrates of VAs in young competitive athletes.Method And ResultsWe studied 288 competitive athletes (age range, 16-35 years; median age, 21 years) and 144 sedentary individuals matched for age and sex who underwent 12-lead 24-hour ambulatory electrocardiographic monitoring. VAs were evaluated in terms of number, complexity (ie, couplet, triplet, or nonsustained ventricular tachycardia), exercise inducibility, and morphologic features. Twenty-eight athletes (10%) and 13 sedentary individuals (11%) showed >10 isolated premature ventricular beats (PVBs) or ≥1 complex VA (P=0.81). Athletes with >10 isolated PVBs or ≥1 complex VA were older (median age, 26 versus 20 years; P=0.008) but did not differ with regard to type of sport, hours of training, and years of activity compared with the remaining athletes. All athletes with >10 isolated PVBs or ≥1 complex VA had a normal echocardiographic examination; 17 of them showing >500 isolated PVBs, exercise-induced PVBs, and/or complex VA underwent additional cardiac magnetic resonance, which demonstrated nonischemic left ventricular late gadolinium enhancement in 3 athletes with right bundle branch block PVBs morphologic features.ConclusionsThe prevalence of >10 isolated PVBs or ≥1 complex VA at 24-hour ambulatory electrocardiographic monitoring did not differ between young competitive athletes and sedentary individuals and was unrelated to type, intensity, and years of sports practice. An underlying myocardial substrate was uncommon and distinctively associated with right bundle branch block VA morphologic features.© 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

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