<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Sudden death (SD) in athletes is a potential avoidable dramatic scenario. When done regularly, cardiological evaluation increases the chances of diagnosing ventricular pre-excitation. Consequently, the following question arises: what is the real incidence of SD risk in athletes with Wolff-Parkinson-White (WPW) syndrome/pattern? This study included 84 consecutive patients diagnosed with WPW and was designed as a retrospective analysis of data acquired between 2011 and 2021 to answer this question. The patients were evaluated using a 12-lead electrocardiogram (ECG), echocardiography, stress test, and electrophysiological study (EPS). The SD risk linked to WPW was defined as ≥ 1 of the following: the anterograde effective refractory period (AERP) of the accessory pathway (AP) ≤ 250 ms, atrial fibrillation (AF) with the shortest RR pre-excited interval ≤ 250 ms, syncope during AF or atrioventricular reentry tachycardia. The athletes with WPW pattern (n=25) or syndrome (n=59) at risk of SD were identified and treated with radiofrequency ablation (RFA). The mean age was 19.83 (10–29) years; 66.6% were men. Seventeen athletes (n=17; 20.23%) were found with SD risk: 15 (n=15; 17.85%) in the WPW syndrome group and 2 (n=2; 2.38%) in the WPW pattern group. During the EPS, n=4 developed syncope: 1 during antidromic tachycardia and 3 during pre-excited AF. RFA was curative in 96.42% of cases. The EPS is mandatory to identify athletes with short AERP APs linked to an increased risk of SD. RFA is the intervention that settles the patients into a risk-free area, allowing resumption of sports shortly afterward.</p>
</abstract>

Sudden death (SD) in athletes is a potential avoidable dramatic scenario. When done regularly, cardiological evaluation increases the chances of diagnosing ventricular pre-excitation. Consequently, the following question arises: what is the real incidence of SD risk in athletes with Wolff-Parkinson-White (WPW) syndrome/pattern? This study included 84 consecutive patients diagnosed with WPW and was designed as a retrospective analysis of data acquired between 2011 and 2021 to answer this question. The patients were evaluated using a 12-lead electrocardiogram (ECG), echocardiography, stress test, and electrophysiological study (EPS). The SD risk linked to WPW was defined as ≥ 1 of the following: the anterograde effective refractory period (AERP) of the accessory pathway (AP) ≤ 250 ms, atrial fibrillation (AF) with the shortest RR pre-excited interval ≤ 250 ms, syncope during AF or atrioventricular reentry tachycardia. The athletes with WPW pattern (n=25) or syndrome (n=59) at risk of SD were identified and treated with radiofrequency ablation (RFA). The mean age was 19.83 (10–29) years; 66.6% were men. Seventeen athletes (n=17; 20.23%) were found with SD risk: 15 (n=15; 17.85%) in the WPW syndrome group and 2 (n=2; 2.38%) in the WPW pattern group. During the EPS, n=4 developed syncope: 1 during antidromic tachycardia and 3 during pre-excited AF. RFA was curative in 96.42% of cases. The EPS is mandatory to identify athletes with short AERP APs linked to an increased risk of SD. RFA is the intervention that settles the patients into a risk-free area, allowing resumption of sports shortly afterward.

The Risk of Sudden Death Associated with Symptomatic and Asymptomatic Ventricular Pre-excitation in Athletes

University of Medicine and Pharmacy “Victor Babeş” Timișoara

Internal Medicine and Cardiology Department, Colțea Clinical Hospital

Carol Davila University of Medicine and Pharmacy

University of Medicine and Pharmacy Timișoara

“Iuliu Hatieganu” University of Medicine and Pharmacy

5th Department of Internal Medicine, Cardiology-Rehabilitation

“Victor Babeş” University of Medicine and Pharmacy Timișoara

Doctoral School of Biological and Biomedical Sciences

Romanian Journal of Cardiology

This work is licensed under the Creative Commons Attribution 4.0 International License.

Sudden death (SD) in athletes is a potential avoidable dramatic scenario. When done regularly, cardiological evaluation increases the chances of diagnosing...

The Risk of Sudden Death Associated with Symptomatic and Asymptomatic Ventricular Pre-excitation in Athletes

Article Category: Original Article

Pubblicato online: 08 set 2022

Pagine: 85 - 92

DOI: https://doi.org/10.2478/rjc-2022-0016

Parole chiave
athletes, sudden cardiac death, Wolff-Parkinson-White syndrome, atrial fibrillation, electrophysiological study, catheter ablation

© 2022 Alina Gabriela Negru et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

The Risk of Sudden Death Associated with Symptomatic and Asymptomatic Ventricular Pre-excitation in Athletes

Article Category: Original Article

Pubblicato online: 08 set 2022

Pagine: 85 - 92

DOI: https://doi.org/10.2478/rjc-2022-0016

Parole chiaveathletes, sudden cardiac death, Wolff-Parkinson-White syndrome, atrial fibrillation, electrophysiological study, catheter ablation

© 2022 Alina Gabriela Negru et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Parole chiave
athletes, sudden cardiac death, Wolff-Parkinson-White syndrome, atrial fibrillation, electrophysiological study, catheter ablation