Key result
An exercise test simulating competition effort successfully provoked tachyarrhythmia consistent with sports heart rate monitor readings in a 36-year-old marathon runner.
Why the study?
Exercise-induced arrhythmia diagnosis can be challenging, especially when standard tests fail to provoke arrhythmia and symptoms mimic psychiatric conditions.
Case Report (n=1)
This case highlights the diagnostic utility of sports heart rate monitors and the need for competition-simulating exercise tests to diagnose exercise-induced arrhythmias.
Competition-simulating exercise testing may aid arrhythmia diagnosis in athletes; hypothesis-generating and requires prospective validation before adoption.
A 36-year-old professional marathon runner reported sudden heart palpitations occurring during competitions, with heart rates (HR) of 230 bpm recorded on sports HR monitor (HRM) over 4 years. These episodes subsided upon the cessation of exercise. Electrocardiograms, echocardiography, and cardiac magnetic resonance imaging results were borderline for athlete's heart. Because an electrophysiology study and standard exercise tests provoked no arrhythmia, doctors suspected Munchhausen syndrome. Ultimately, an exercise test that simulated the physical effort during a competition provoked tachyarrhythmia consistent with the HRM readings. This case demonstrates the diagnostic difficulties related to exercise-induced arrhythmia and the diagnostic usefulness of sports HRMs.
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Gajda et al. (2023) conducted a case report in Exercise-induced arrhythmia (n=1). Exercise test simulating competition effort vs. Standard exercise tests was evaluated on Provocation of tachyarrhythmia. An exercise test simulating competition effort successfully provoked tachyarrhythmia consistent with sports heart rate monitor readings in a 36-year-old marathon runner.
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