Key result
Normal echocardiography clears an asymptomatic athlete with profound first- and second-degree AV block for sports.
Why the study?
Profound first-degree AV block and Mobitz type I second-degree AV block are uncommon in athletes and often require case-by-case workup to evaluate for structural cardiac abnormalities.
Case Report (n=1)
Profound first-degree AV block with Wenckebach in an asymptomatic athlete can be a benign physiological adaptation, permitting unrestricted sports participation after structural heart disease is excluded.
May support clearance for asymptomatic athletes after normal echo; hypothesis-generating for benign physiological adaptation.
First-degree atrioventricular (AV) block (PR interval >200 ms) is commonly observed among screening electrocardiogram (ECG) in athletes. Profound first-degree AV block (PR interval >400 ms) and Mobitz type I (Wenckebach) second-degree AV block are generally uncommon and often require further workup on a case-by-case basis, particularly when there is concern for a structural cardiac abnormality. In this case, we present an example of an asymptomatic profound first-degree AV block with Mobitz type I (Wenckebach) second-degree AV block. Transthoracic echocardiogram and stress echocardiogram were unremarkable and the patient was cleared to participate in sports without any restriction. Physicians managing athletes should be aware of ECG features that require additional evaluation and cardiology consultation.
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Stumph et al. (2023) conducted a case report in Profound first-degree AV block with Mobitz type I (Wenckebach) second-degree AV block (n=1). Profound first-degree AV block was evaluated. An asymptomatic high-level basketball athlete with profound first-degree and Mobitz type I second-degree AV block had unremarkable echocardiographic workup and was cleared for sports.
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