Table 5.
Athlete’s heart vs. arrhythmogenic right ventricular cardiomyopathy
| Athlete’s heart | ARVC | |
|---|---|---|
| Family history | No | ARVC or SCD |
| ECG abnormalities | Training-related ECG changes such as incomplete right bundle branch block increased in QRS voltages and early repolarization. Right precordial early repolarization variant with negative T-wave preceded by J-point/ST-segment elevation. | Right precordial T-wave inversion, ε waves, right precordial QRS prolongation with delayed S-wave upstroke and terminal activation delay (>55 ms), low QRS voltages |
| Symptoms | No | Palpitations, syncope, cardiac arrest |
| RV dilation | Yes (mainly main RV body) | yes (mainly RVOT) |
| RV/LV dilation ratio | RV/LV <1 | RV/LV >1 |
| Global RV dysfunction | No (or mild) | Yes |
| Regional RV wall motion abnormalities | No | A-dyskinesia; bulging |
| LGE at cardiac magnetic resonance | No (or only junctional) | RV and/or LV (non-ischaemic pattern) |
| Ventricular arrhythmias | No | Yes |
LGE, late gadolinium enhancement; LV, left ventricle; RV, right ventricle; RVOT, right ventricular outflow tract; SCD, sudden cardiac death.