Lai Ernest, Chung Eugene H
School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Sports Cardiology Clinic, Frankel Cardiovascular Center, University of Michigan Medical School, Michigan Medicine, 1500 E Medical Center Dr SPC 5856, Ann Arbor, MI, 48109-5856, USA.
Curr Treat Options Cardiovasc Med. 2017 Oct 9;19(11):86. doi: 10.1007/s11936-017-0583-x.
Management of atrial fibrillation, premature ventricular contractions, and ventricular tachycardia without underlying cardiac disease or arrhythmogenic conditions differs in athletes from the general population. Athletes tend to be younger, healthier individuals with few comorbidities. Therapies that work well in the general population may not be appropriate or preferable for athletes. Management strategies include deconditioning, pharmacologic therapy, such as rate control with β-blockers or non-dihydropyridine calcium channel blockers and rhythm control with class I or class III antiarrhythmic drugs, and catheter ablation. Deconditioning is not preferred by athletes because of lost playing time. Pharmacologic therapy is well tolerated among most individuals, but is not as favorable in athletes. Rate control medications can reduce performance and β-blockers, in particular, are prohibited in many sports. Antiarrhythmic drugs are preferred over rate control with athletes, but many, especially younger athletes, may not like the idea of long-term medical therapy. Catheter ablation has been proven to be safe and efficacious, may eliminate the need for long-term medical therapy, and is supported by the major societies (AHA, ACC, ESC).
在无潜在心脏病或致心律失常情况时，运动员心房颤动、室性早搏和室性心动过速的管理与普通人群不同。运动员往往更年轻、更健康，合并症较少。在普通人群中有效的治疗方法对运动员可能不合适或并非首选。管理策略包括身体机能减退、药物治疗，如使用β受体阻滞剂或非二氢吡啶类钙通道阻滞剂进行心率控制，以及使用Ⅰ类或Ⅲ类抗心律失常药物进行节律控制，还有导管消融。由于会损失比赛时间，运动员不倾向于身体机能减退。大多数人对药物治疗耐受性良好，但对运动员而言并非如此。心率控制药物会降低运动表现，尤其是β受体阻滞剂在许多运动项目中被禁止使用。与心率控制相比，抗心律失常药物更受运动员青睐，但许多运动员，尤其是年轻运动员，可能不喜欢长期药物治疗的想法。导管消融已被证明是安全有效的，可能无需长期药物治疗，并且得到了主要学会（美国心脏协会、美国心脏病学会、欧洲心脏病学会）的支持。
