Influence of training on the number and complexity of frequent VPBs in healthy athletes

OBJECTIVE: Frequent ventricular premature beats (VPBs) may be discovered during preparticipation screening in asymptomatic apparently healthy athletes. Some authors hypothesize that they may be a manifestation of 'athlete's heart' and suggest a deconditioning period, which should document a regression of arrhythmias, to exclude a concealed disease. METHODS: To test this hypothesis, we analysed 87 asymptomatic healthy athletes with frequent VPB (>100/24 h). Of these, 44 (group D) underwent at least 3 months' detraining, whereas 43 (group C) continued sporting activity. Athletes underwent 24-h Holter monitoring at the baseline after 5.2 ± 4 (group D) and 7.2 ± 5 (group C) months. RESULTS: Basal characteristics were similar in both groups. Comparison of the basal and follow-up Holter results revealed no significant difference in the mean number of VPB/24 h in either group. In group D, the number of VPB/24 h declined from 8126 ± 8129 to 7998 ± 10 976 (P = 0.48), whereas in group C it rose from 6027 ± 6374 to 6600 ± 8590 (P = 0.51). VPB either disappeared or were markedly reduced (<100 VPB/24 h) in 2/44 (4.5%) group D and 4/43 (9%) group C athletes.In neither group did the number of couplets or nonsustained ventricular tachycardia change significantly. CONCLUSION: In healthy athletes, frequent VPBs discovered by chance during preparticipation screening may not be a manifestation of 'athlete's heart', but may depend on other causes; in the latter case screening may simply reveal a pre-existing asymptomatic phenomenon; the usefulness of detraining in ascertaining eligibility for sport should be further investigated.