Kardiyak Aritmiler ve Spor
Özet
Sporcularda, miyokardın artmış hacim ve basınç yükü ve artmış vagal tonusun bir sonucu olarak EKG değişiklikleri ve aritmiler, normal popülasyona göre daha yaygındır. Sporcularda ani ölümler, %95’i kardiyovasküler nedenlerle ve çoğunlukla asemptomatik veya çok detayda kalan anormalliklerle meydana gelmektedir. Klinisyenlerin sporcular arasındaki fizyolojik ve patolojik EKG değişikliklerini ayırt etmelerine yardımcı olmak için çeşitli kılavuzlar geliştirilmiştir. Sporcularda kardiyak değerlendirmenin, güncel kılavuzların önerileri benimsenerek, bu konuda deneyimi olan kardiyolog ve spor hekimleri işbirliği içinde ayrıntılı olarak yapılması gerekmektedir. Erişkin sporcularda aritmilerle konusunda düzenli aralıklarla kılavuzlar yayınlanmakta iken çocuklarda kısıtlı sayıda araştırma mevcuttur. Aritmisi olan çocuk hastalarla ilgili spor önerileri konusunda kapsamlı güncel kılavuzlara ihtiyaç vardır.
Referanslar
Corrado D, Pelliccia A, Heidbuchel H, Sharma S, Link M, Basso C, et al. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. 2010;31(2):243-59.
Uberoi A, Stein R, Perez MV, Freeman J, Wheeler M, Dewey F, et al. Interpretation of the electrocardiogram of young athletes. 2011;124(6):746-57.
Heidbuchel H, Adami PE, Antz M, Braunschweig F, Delise P, Scherr D, et al. Recommendations for participation in leisure-time physical activity and competitive sports in patients with arrhythmias and potentially arrhythmogenic conditions: Part 1: Supraventricular arrhythmias. A position statement of the Section of Sports Cardiology and Exercise from the European Association of Preventive Cardiology (EAPC) and the European Heart Rhythm Association (EHRA), both associations of the European Society of Cardiology. European journal of preventive cardiology. 2021;28(14):1539-51.
Heidbuchel H, Arbelo E, D'Ascenzi F, Borjesson M, Boveda S, Castelletti S, et al. Recommendations for participation in leisure-time physical activity and competitive sports of patients with arrhythmias and potentially arrhythmogenic conditions. Part 2: ventricular arrhythmias, channelopathies, and implantable defibrillators. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2021;23(1):147-8.
Zipes DP, Link MS, Ackerman MJ, Kovacs RJ, Myerburg RJ, Estes NAM, 3rd. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 9: Arrhythmias and Conduction Defects: A Scientific Statement From the American Heart Association and American College of Cardiology. Journal of the American College of Cardiology. 2015;66(21):2412-23.
Hoogsteen J, Bennekers J, van der Wall E, van Hemel N, Wilde A, Crijns H, et al. Recommendations and cardiological evaluation of athletes with arrhythmias: Part 1. 2004;12(4):157.
McClaskey D, Lee D, Buch EJSm. Outcomes among athletes with arrhythmias and electrocardiographic abnormalities: Implications for ECG interpretation. 2013;43:979-91.
Graziano F, Mastella G, Merkely B, Vago H, Corrado D, Zorzi AJE. Ventricular arrhythmias recorded on 12-lead ambulatory electrocardiogram monitoring in healthy volunteer athletes and controls: what is common and what is not. 2023;25(9):euad255.
Bjørnstad H, Storstein L, Dyre Meen H, Hals OJC. Ambulatory electrocardiographic findings in top athletes, athletic students and control subjects. 1994;84(1):42-50.
Zehender M, Meinertz T, Keul J, Just HJAhj. ECG variants and cardiac arrhythmias in athletes: clinical relevance and prognostic importance. 1990;119(6):1378-91.
Doniger SJ, Sharieff GQJPC. Pediatric dysrhythmias. 2006;53(1):85-105.
Katyal A, Li CO, Franciosi S, Sanatani SJFiP. The safety of sports in children with inherited arrhythmia substrates. 2023;11:1151286.
Al-Khatib SM, Pritchett ELJAhj. Clinical features of wolff-parkinson-white syndrome. 1999;138(3):403-13.
Bilici M, Demir FJDTD. Pediatrik disritmiler. 2015;42(1):128-35.
Masrur S, Memon S, Thompson PDJCc. Brugada syndrome, exercise, and exercise testing. 2015;38(5):323-6.
Referanslar
Corrado D, Pelliccia A, Heidbuchel H, Sharma S, Link M, Basso C, et al. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. 2010;31(2):243-59.
Uberoi A, Stein R, Perez MV, Freeman J, Wheeler M, Dewey F, et al. Interpretation of the electrocardiogram of young athletes. 2011;124(6):746-57.
Heidbuchel H, Adami PE, Antz M, Braunschweig F, Delise P, Scherr D, et al. Recommendations for participation in leisure-time physical activity and competitive sports in patients with arrhythmias and potentially arrhythmogenic conditions: Part 1: Supraventricular arrhythmias. A position statement of the Section of Sports Cardiology and Exercise from the European Association of Preventive Cardiology (EAPC) and the European Heart Rhythm Association (EHRA), both associations of the European Society of Cardiology. European journal of preventive cardiology. 2021;28(14):1539-51.
Heidbuchel H, Arbelo E, D'Ascenzi F, Borjesson M, Boveda S, Castelletti S, et al. Recommendations for participation in leisure-time physical activity and competitive sports of patients with arrhythmias and potentially arrhythmogenic conditions. Part 2: ventricular arrhythmias, channelopathies, and implantable defibrillators. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2021;23(1):147-8.
Zipes DP, Link MS, Ackerman MJ, Kovacs RJ, Myerburg RJ, Estes NAM, 3rd. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 9: Arrhythmias and Conduction Defects: A Scientific Statement From the American Heart Association and American College of Cardiology. Journal of the American College of Cardiology. 2015;66(21):2412-23.
Hoogsteen J, Bennekers J, van der Wall E, van Hemel N, Wilde A, Crijns H, et al. Recommendations and cardiological evaluation of athletes with arrhythmias: Part 1. 2004;12(4):157.
McClaskey D, Lee D, Buch EJSm. Outcomes among athletes with arrhythmias and electrocardiographic abnormalities: Implications for ECG interpretation. 2013;43:979-91.
Graziano F, Mastella G, Merkely B, Vago H, Corrado D, Zorzi AJE. Ventricular arrhythmias recorded on 12-lead ambulatory electrocardiogram monitoring in healthy volunteer athletes and controls: what is common and what is not. 2023;25(9):euad255.
Bjørnstad H, Storstein L, Dyre Meen H, Hals OJC. Ambulatory electrocardiographic findings in top athletes, athletic students and control subjects. 1994;84(1):42-50.
Zehender M, Meinertz T, Keul J, Just HJAhj. ECG variants and cardiac arrhythmias in athletes: clinical relevance and prognostic importance. 1990;119(6):1378-91.
Doniger SJ, Sharieff GQJPC. Pediatric dysrhythmias. 2006;53(1):85-105.
Katyal A, Li CO, Franciosi S, Sanatani SJFiP. The safety of sports in children with inherited arrhythmia substrates. 2023;11:1151286.
Al-Khatib SM, Pritchett ELJAhj. Clinical features of wolff-parkinson-white syndrome. 1999;138(3):403-13.
Bilici M, Demir FJDTD. Pediatrik disritmiler. 2015;42(1):128-35.
Masrur S, Memon S, Thompson PDJCc. Brugada syndrome, exercise, and exercise testing. 2015;38(5):323-6.
