ΑΡΡΥΘΜΙA KAI SPORTS

TO SCREEN OR NOT TO SCREEN

EVANGELIA KOUIDI

CARDIOLOGIST

PROFESSOR OF SPORTS MEDICINE

ARISTOTLE UNIVERSITY OF THESSALONIKI, GREECE

SPORTS MEDICINE LABORATORY

DIRECTOR: PROF. A. DELIGIANNIS

Wen CP et al. Lancet 2011; 378: 1244–53

Nigam A, Juneau M. The

Lancet 2011; 378:1202-3Lee et al. JACC 2014; 64(5):472-81

Chevalier L, et al. Eur J Cardiov Prev Rehabil 2009, 16:365–370

CARDIOVASCULAR EVENTS DURING EXERCISE

6.5/100.000 persons/years

10.8/100.000 males/year 2.2/100.000 females/year

Myerburg RJ, Vetter VL. Circulation 2007; 116: 2616-26.

Maron BJ e al, JACC 2014; 63: 1636-43

Thompson P et al Circulation 2007; 115: 2358-68

Deligiannis A, et al. Eur J Cardiovasc Prev Rehabil 2006; 13: 687-694

Furlanello F, et al. Eur J Cardiovasc Prev Rehabil 2007; 14: 487-494

Link M, Estes M. J Cardiovasc Electrophysiol, 2010; 21: 1184-1189

Doerer J, et al. Am J Cardiol 2007; 99: 857- 9

Chandra N et al. J Am Coll Cardiol 2013;61:1027–40

Organization of

First Aids in

Arena

Identification of

Target Groups

(High Risk Family)

Pre-

participation

Health

Screening

Corrado D et al. Eur Heart J 2010;31:243-259

Screening work-up according to the proposed

criteria for ECG interpretation in athletes

Asif I, Drezner J. Prog Cardiovasc Dis 2012; 54:445-

450

Drezner JA, Ackerman MJ, Anderson J et al. Br J Sports Med 2013; 47: 122–4.

Electrocardiographic interpretation in athletes:

the “Seattle criteria”

Sens 91%

Spec 89%

Myerburg RJ, Vetter VL. Circulation 2007; 116: 2616-26.

.

22.205 athletes

• Abnormal ECG pattern 45%

• Cardiovascular Disorders 10%

• Disqualified 1%

Eur Heart J 2005; 26:1422-45.

Pelliccia A et al. Eur Heart J 2005; 26:1422-45.

In the absence of evidence of

structural heart disease and in the absence of

symptoms other than occasional palpitation,

no evaluation other than a 12-lead ECG is necessary.

Premature Contractions

Link M, Mark Estes NA. J Cardiovasc Electrophysiol, 2010; 21: 1184-1189

Bethesda Conference #36 and the European Society

of Cardiology Consensus Recommendations Revisited

A. Pelliccia,D. Zipes,B. Maron JACC, 2008; 52:1990

Biffi A, et al. JACC 2004; 44: 1053-1058

Salerno J, et al. Arch Pediatr Adolesc Med. 2009;163(3):268-274

PAROXYSMAL SUPRAVENTRICULAR

TACHYCARDIA

16 years old male runner

If the individual wants to perform competitive

athletic activity, definitive treatment by ablation

is recommended.

Moreover, drug treatment may not be

tolerated, may be illegal, or may even be

dangerous during competitive sports.

PAROXYSMAL SUPRAVENTRICULAR

TACHYCARDIA WITHOUT PRE-EXCITATION

Heidbuchel H, et al. Eur J Cardiovasc Prev Rehabil 2006; 13: 475

Eur Heart J 2005; 26:1422-45.

Maron B and Pelliccia A. Circulation 2006;114:1633-1644

Lavie C, et al. Current Sports Medicine Reports 2015; 15: 104-110

Lluı´s Mont et al. Europace 2009; 11: 11–17 Aizer A, et al. Am J Cardiol 2009; 103(11): 1572–1577

D’ Andrea A, et al. Am Heart J 2010;159:1155-61

Endurance sports:

• high vagal tone

• increased left atrial dimensions

• increase in atrial wall strain/stretch

Baldesberger S. Eur Heart J 2008; 29(1):71-8.

Eur Heart J 2005; 26:1422-45.

17 years old male swimmer

Cohen M et al. Heart Rhythm 2012; 9: 1006-24

Bethesda Conference #36 and the European Society

of Cardiology Consensus Recommendations Revisited

A. Pelliccia,D. Zipes,B. Maron JACC, 2008; 52:1990

Svendsen J et al. Europace 2013; 15, 750–753

Santinelli V, et al. J Am Coll Cardiol 2009; 53: 275-80

Johnson JN, Ackerman MJ. Br J Sports Med 2013, 47, 28–33

QT Abnormalities

Johnson JN, Ackerman MJ. Br J Sports Med 2013, 47, 28–33

Pelliccia A et al. Eur Heart J 2005; 26:1422-45.

Lampert R, et al. J Cardiovasc Electrophysiol, 2006;

17: 11-15

Current Sports Medicine Reports 2015; 14: 104-110

Thiene G et al. Cell Tissue Res 2012; 348:315–318

ΠΡΟΛΗΨΗ

ΕΚΠΑΙΔΕΥΣΗ - ΕΝΗΜΕΡΩΣΗ

Centre for Cardiac Risk in Younger

Persons (CRY Centre)

Aim : At CRY all young individuals (14-35) have the

opportunity to be screened. Morover CRY provide timely,

comprehensive assessment of families where SCD has

occurred or young people with worrying cardiac symptoms

Tests : ECG, Echo, Exercise Test, Heart rhythm monitor all

on one day, followed by Consultation with Consultant (family

tree etc)

Higgins J et al. JACC 2011;58:988-92 Halkin A, et al. JACC 2012;60:2271–6

Steinvill et al. JACC 2011;57:1291-6

ΕΡΓΑΣΤΗΡΙΟ ΑΘΛΗΤΙΑΤΡΙΚΗΣ ΤΕΦΑΑ ΑΠΘ

ΙΑΤΡΕΙΟ ΠΡΟΑΓΩΝΙΣΤΙΚΟΥ ΕΛΕΓΧΟΥ

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