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Clinical Articles, Lead Article

Young Investigator Award

‘Lifelong endurance athletes – what is the burden of arrhythmias in this group?’ This was the question addressed by the winner of the Young Investigator Award (Clinical Science) – Dr Ahmed Merghani (St George’s Hospital, London). In an elegant study, he analysed 152 athletes >40 years age with >10 years of endurance exercise with age, sex and ethnicity matched veteran controls (<150 mins exercise/week). All participants underwent a 24hr Holter monitor, cardiac magnetic resonance imaging (MRI) scan and cardiac computed tomography (CT) scan. Interestingly, in veteran athletes, there was a higher incidence of narrow complex tachycardias, pauses >2.5s and runs of non-sustained ventricular tachycardia.

Dr Ahmed Merghani (St George’s Hospital, London)

Dr Ahmed Merghani (St George’s Hospital, London)

Cardiac MRI was then performed to assess the underlying substrate for these arrhythmias; overall 16% of male veteran athletes had mid-myocardial or epicardial scarring whilst 40% had subendocardial scar (suggestive of an ischaemic aetiology). A cardiac CT was then performed alongside a calcium score. Intriguingly, male veteran athletes had significantly higher incidences of luminal stenosis >50% and >2 vessel involvement with coronary disease. A moderate amount of exercise appeared protective (in terms of calcium score) compared to no exercise and extreme exercise. The moderators praised the design and quality of the study whilst also noting that it raised further questions regarding screening of endurance athletes >40 years age.

Published on: November 8, 2016

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

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