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7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation, Annual Assembly of the German and the Austrian Society of Physical Medicine and Rehabilitation

Austrian Society of Physical Medicine and Rehabilitation

26.-29.10.2011, Salzburg, Austria

Holter monitoring in young athletes: what’s new in 2011?

Meeting Abstract

  • corresponding author presenting/speaker Yulia Venevtseva - Tula State University, Tula, Russian Federation
  • Aleksandr Melnikov - Tula State University, Tula, Russian Federation
  • Svetlana Antonenko - Tula State University, Tula, Russian Federation
  • Tatjana Gomova - Tula State University, Tula, Russian Federation

7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation. Salzburg, 26.-29.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11esm084

DOI: 10.3205/11esm084, URN: urn:nbn:de:0183-11esm0847

Published: October 24, 2011

© 2011 Venevtseva et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective: It is widely known that the most prevalent cause of death in young athletes is life-threatening arrhythmia. Preparticipation screening is recommended by the ESC and aims to reduce sudden cardiac deaths. Holter monitoring providing valuable cardiologic information was used in sport during 30 years [1].

The purpose of the study was to compare the rate of ECG-disturbances in contemporary adolescents with different habitual physical activity level.

Material/Methods: 24 h ECG was recorded in 22 athletes (A) 11-18 years (mean, M+/-m, 14.8+/-0.5 yr) participating in different sport disciplines and 28 non-sportsmen (NS, 17.1+/-0.3 yr). 15 athletes (15.6+/-0.5 yr) and 24 NS (16.9+/-2.2 yr) underwent polyfunctional monitoring (ECG, BP and respiratory inductance plethysmography).

Results: Athletes needed further evaluation due to ECGs or history/symptoms (casual BP elevation, overtraining). We found no differences in height and weight between A and NS in ECG group (height 172.8+/-3.2 and 173.6+/-1.7 kg; weight 60.3+/-3.5 and 60.9+/-1.8 kg), while NS in BP group were heavier (height 174.3+/-2.0 and 179.7+/-1.8 cm; weight 67.2+/-3.4 vs 85.0+/-4.0 kg, p<0.01).

Only day and night SBP in A was lower (day 130.7+/-2.7 and 138.0+/-2.4 mm Hg, p=0.03; night 113.6+/-2.9 and 119.4+/-2.3 mm Hg, p=0.05) and apnoea/hypopnoea index (AHI) in A was smaller (5,3+/-0,7 and 9,8+/-2,0; p<0,05).

Early repolarisation was seen in the day-time in 28.5% of A and in 4.2% of NS (p<0.01), whereas no difference in the night was obtained (42.9 and 37.5%).

Premature supraventricular beats >100/24h were seen in 24.1 and 21.1%; ventricular premature beats (VPBs) – in 18.2% of A and 40.4% of NS (p<0.05).

No differences were detected in AV II degree block (18.2 vs 15.4%) and SA block (33.3 vs 18.3%, p>0.05). Transient long QT-interval (<10% of time) obtained in 36.4% of A and 17.4% of NS, short QT-interval – in 9.1 vs. 17.3% in NS. Short PQ-interval existed in 21.2% of A (WPW in 3 A) vs. 15.4% of NS.

Heart rate variability analysis revealed that power spectra of low frequency band (LF, linked to the sympathetic and vasomotor modulation) both in the day-time and night and very low frequency power (reflects slow regulatory mechanisms, e.g. the renin-angiotensin system, thermoregulation) – only in night in A was significantly bigger than in NS. Power of high frequency band (related to parasympathetic activity) did not differ.

EchoCG examinations in all A were normal except mild mitral (in 35%) and tricuspid (in 18%) valve prolapse.

Conclusion: Early repolarisation in the day-time in young athletes exists more frequently, VPBs – more seldom, day systolic BP is lower and night breathing – more regular than in sedentary adolescents. Thus, Holter ECG+BP – monitoring is a useful tool for identification resting ECG features and optimization training volume and intensity in young athletes.


References

1.
Hanne-Paparo N, Kellermann JJ. Long-term Holter ECG monitoring of athletes. Med Sci Sports Exerc.1981;13(5):294-8.
2.
Delise P, Lanari E, Sitta N, Centa M, Allocca G, Biffi A. Influence of training on the number and complexity of frequent VPBs in healthy athletes. J Cardiovasc Med (Hagerstown). 2011;12(3):157-61.