Why the study?
Cardiac testing in asymptomatic healthy athletes can disclose long nocturnal pauses not typical for physiological adaptation to exercise, raising questions about physiology, potential pathologies, and management.
This narrative review discusses the physiology, potential pathologies, and management strategies (including cardioneuroablation) for asymptomatic nocturnal pauses in athletes.
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Long nocturnal pauses in asymptomatic athletes warrant cautious interpretation to avoid over-testing; leaves open evidence-based management thresholds.
Athletes undergo mandatory or voluntary cardiac testing, which may include 24-h ambulatory electrocardiogram monitoring. This study can on occasion disclose nocturnal pauses in otherwise asymptomatic healthy individuals. In some athletes, particularly those engaging in endurance or mixed sports, the pauses can be longer than 2–3 s and/or be caused by sinus arrest high-degree atrioventricular block not typical for physiological adaptation to exercise. The manuscript discusses the physiology and potential pathologies behind long nocturnal pauses in athletes. Several management strategies are proposed including emerging treatment techniques such as cardioneuroablation.
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Łukasz A. Małek (2024) studied this question.
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