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运动员危及生命的室性心律失常的导管消融术

Catheter Ablation of Life-Threatening Ventricular Arrhythmias in Athletes.

作者信息

Tarantino Nicola, Rocca Domenico G Della, Cruz Nicole S De Leon De La, Manheimer Eric D, Magnocavallo Michele, Lavalle Carlo, Gianni Carola, Mohanty Sanghamitra, Trivedi Chintan, Al-Ahmad Amin, Horton Rodney P, Bassiouny Mohamed, Burkhardt J David, Gallinghouse G Joseph, Forleo Giovanni B, Biase Luigi Di, Natale Andrea

机构信息

Arrhythmia Service, Department of Medicine, Division of Cardiology, Montefiore Medical Center, 10467 Bronx, NY, USA.

St. David's Medical Center, Texas Cardiac Arrhythmia Institute, 3000 N. IH-35, Suite 720, Austin, TX 78705, USA.

出版信息

Medicina (Kaunas). 2021 Feb 26;57(3):205. doi: 10.3390/medicina57030205.

Abstract

A recent surveillance analysis indicates that cardiac arrest/death occurs in ≈1:50,000 professional or semi-professional athletes, and the most common cause is attributable to life-threatening ventricular arrhythmias (VAs). It is critically important to diagnose any inherited/acquired cardiac disease, including coronary artery disease, since it frequently represents the arrhythmogenic substrate in a substantial part of the athletes presenting with major VAs. New insights indicate that athletes develop a specific electro-anatomical remodeling, with peculiar anatomic distribution and VAs patterns. However, because of the scarcity of clinical data concerning the natural history of VAs in sports performers, there are no dedicated recommendations for VA ablation. The treatment remains at the mercy of several individual factors, including the type of VA, the athlete's age, and the operator's expertise. With the present review, we aimed to illustrate the prevalence, electrocardiographic (ECG) features, and imaging correlations of the most common VAs in athletes, focusing on etiology, outcomes, and sports eligibility after catheter ablation.

摘要

最近的一项监测分析表明,心脏骤停/死亡发生在约1:50000的职业或半职业运动员中,最常见的原因是危及生命的室性心律失常(VA)。诊断任何遗传性/获得性心脏病,包括冠状动脉疾病,至关重要,因为在出现严重VA的大部分运动员中,它常常是致心律失常的基质。新的见解表明,运动员会发生特定的电解剖重塑,具有独特的解剖分布和VA模式。然而,由于关于体育运动员VA自然病史的临床数据稀缺,目前尚无针对VA消融的专门建议。治疗仍取决于多个个体因素,包括VA的类型、运动员的年龄和操作者的专业技能。通过本综述,我们旨在阐述运动员中最常见VA的患病率、心电图(ECG)特征及影像学关联,重点关注导管消融后的病因、结局和运动资格。

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