Table 1.

Summary of Conditions Associated with Cardiac Arrhythmia in Athletes

Condition	Description	Recommendation [2, 3]
Hypertrophic Cardiomyopathy	Autosomal dominant inheritance, generalized or localized hypertrophy of the left ventricle, heart failure, atrial and ventricular arrhythmia, syncope, sudden death	No competitive sports, consider defibrillator implantation
Commotio Cordis	Blunt force injury to the chest resulting in ventricular fibrillation	Workup to rule out underlying heart disease
Anomalous origin of coronary arteries	Variant site of origin of right or left coronary artery, myocardial hypoperfusion, ventricular arrhythmia	No competitive sports, consider referral for surgery if myocardial hypo- perfusion is demonstrated
Arrhythmogenic right ventricular dysplasia / cardiomyopathy	Enlargement, dysfunction, and fibro-fatty replacement of the right ventricle, T-wave inversions in leads V1–3 or Epsilon waves on baseline ECG of some but not all patients, ventricular tachycardia (with left bundle branch like morphology), exertional pre-syncope, syncope, or sudden death	No competitive sports, defibrillator implantation, beta blockers or catheter ablation for ventricular tachycardia suppression and shock reduction
Idiopathic ventricular tachycardia	Monomorphic ventricular tachycardia, normal cardiac structure and function	Consider catheter ablation
Atrial fibrillation / flutter	Most common arrhythmia in athletes, associated with endurance training	Competitive sports ok if structural heart disease and rapid ventricular rate are absent, consider catheter ablation
The long QT syndrome	Prolonged and abnormal cardiac repolarization, acquired or inherited	No competitive sports, consider defibrillator implantation
Wolff-Parkinson-White syndrome	Delta wave, atrio-ventricular reentry tachycardia, sudden death risk due to antegrade conduction of atrial fibrillation	Electrophysiology study and catheter ablation in symptomatic athletes, investigate pathway effective refractory period if asymptomatic
Brugada syndrome	Autosomal dominant inheritance, RSR’ and ST segment elevation in right precordial leads, syncope, ventricular fibrillation	No competitive sports, defibrillator implantation
Catecholaminergic polymorphic ventricular tachycardia	Autosomal dominant inheritance, polymorphic ventricular tachycardia or fibrillation triggered by exercise	No competitive sports, defibrillator implantation, beta blocker to reduce events
The short QT syndrome	Shortened and abnormal cardiac repolarization, atrial fibrillation, sudden death	No competitive sports, consider defibrillator implantation