Impact of competitive sport on QT interval prolongation

Background: Regular and sustained physical activity is beneficial for the cardiovascular system. However, sudden cardiac death (SCD) events occasionally occur during physical activity in young and apparently healthy individuals, associated with long QT syndrome (LQTS). The aim of this study is to clarify and characterize SCD among those who practice physical activity as a consequence of LQTS in those involved in physical activity and to determine the possibilities for screening, in order to collaborate with future prevention measures. Material and methods: A systematic review of the Pubmed database was carried out using articles published between 2006 and 2024, in Spanish, English and Portuguese, classified as books and papers, clinical studies, randomized controlled trials, controlled clinical trials, meta-analyses and systematic reviews. For the writing of the final text, only those studies aligned with the objectives established in this research were selected. Results: High-performance athletes can be affected by channelopathies induced by the cardiac remodeling required by the activity. However, studies show that the ability of cardiologists and specialists to analyze and interpret electrocardiograms (ECGs) remains less than ideal. The correct medical approach to sports continuity and performance remains a challenge for the scientific medical community, which adopts restrictive recommendations for athletes diagnosed with any cardiovascular abnormality. Conclusion: LQTS includes various disorders, ranging from genetic mutations to pharmacological interactions and electrolyte imbalances, which are sometimes difficult to diagnose. Due to the risk of malignant arrhythmias and sudden death, early detection and appropriate treatment are essential for accurate diagnosis and treatment. Therefore, it is crucial for the cardiologist to interpret the characteristic electrocardiographic signs of this syndrome.