Link Mark S, Homoud Munther K, Wang Paul J, Estes N A Mark
New England Medical Center, Box #197, 750 Washington Street, Boston, MA 02111, USA.
Curr Sports Med Rep. 2002 Apr;1(2):75-85. doi: 10.1249/00149619-200204000-00004.
Arrhythmia management has undergone a revolution in the past decade. The diagnosis and treatment of arrhythmias in the athlete can be complicated by the need to compete and exercise. Some arrhythmias may be benign and asymptomatic, but others may be life threatening. Sinus bradyarrhythmias are common and even expected in athletes; these are rarely a cause for concern. Heart block is unusual and merits a thorough work-up. Atrial fibrillation may be more common in the athlete, and supraventricular tachycardias other than atrial fibrillation warrant consideration of radiofrequency ablation for cure. Ventricular arrhythmias in the athlete generally occur in the setting of structural heart disease that is genetically determined (hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia, anomalous coronary arteries), or acquired (coronary artery disease, myocarditis, idiopathic dilated cardiomyopathies). In these conditions the arrhythmia is life threatening. Ventricular arrhythmias that occur in the athlete without structural heart disease are not thought to be life threatening. Athletes with structural heart disease and those with exertional syncope merit a complete evaluation.
在过去十年中，心律失常的管理发生了变革。运动员心律失常的诊断和治疗可能因比赛和训练的需求而变得复杂。一些心律失常可能是良性且无症状的，但其他的可能危及生命。窦性心动过缓在运动员中很常见甚至是预期的；这些很少引起担忧。心脏传导阻滞不常见，值得进行全面检查。心房颤动在运动员中可能更常见，除心房颤动外的室上性心动过速值得考虑通过射频消融来治愈。运动员的室性心律失常通常发生在由遗传决定的结构性心脏病（肥厚型心肌病、致心律失常性右心室发育不良、冠状动脉异常）或后天性（冠状动脉疾病、心肌炎、特发性扩张型心肌病）的背景下。在这些情况下，心律失常危及生命。在没有结构性心脏病的运动员中发生的室性心律失常不被认为危及生命。患有结构性心脏病的运动员和有劳力性晕厥的运动员需要进行全面评估。
