September 3, 2019British Journal of Sports Medicine134 citationsOpen Access
How to evaluate premature ventricular beats in the athlete: critical review and proposal of a diagnostic algorithm
Structured PICO
P
Population
Young people and athletes with premature ventricular beats (PVBs)
I
Intervention
Diagnostic algorithm including morphological pattern of ectopic QRS, response to exercise, and cardiac MRI
This review proposes a diagnostic algorithm to help physicians evaluate premature ventricular beats in athletes, stratify risk for sudden cardiac death, and determine eligibility for competitive sports.
Abstract
Although premature ventricular beats (PVBs) in young people and athletes are usually benign, they may rarely mark underlying heart disease and risk of sudden cardiac death during sport. This review addresses the prevalence, clinical meaning and diagnostic/prognostic assessment of PVBs in the athlete. The article focuses on the characteristics of PVBs, such as the morphological pattern of the ectopic QRS and the response to exercise, which accurately stratify risk. We propose an algorithm to help the sport and exercise physician manage the athlete with PVBs. We also address (1) which athletes need more indepth investigation, including cardiac MRI to exclude an underlying pathological myocardial substrate, and (2) which athletes can remain eligible to competitive sports and who needs to be excluded.