Athletes With Abnormal Av Conduction Characterized By An Hv Interval
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Athletes with abnormal AV conduction characterized by an HV interval >90 ms or a His-Purkinje block should have pacemaker implantation.
Supraventricular Tachycardia (SVT): SVTs are not more common in athletes than in the general population of a similar age distribution, with the possible exception of atrial fibrillation (AF). Treatment of these SVTs with catheter ablation is likely to achieve a permanent cure and, in general, is preferable to lifelong therapy with pharmacological agents.
Atrial Fibrillation: Athletes with AF should undergo a work-up that includes thyroid function tests, queries for drug use, ECG, and echocardiogram. Athletes with low-risk AF that is well tolerated and self-terminating may participate in all competitive sports without therapy.
In athletes with AF, when antithrombotic therapy, other than aspirin, is indicated, it is reasonable to consider the bleeding risk in the context of the specific sport before clearance.
Catheter ablation for AF could obviate the need for rate control or antiarrhythmic drugs and should be considered.
Syncope: Athletes with exercise-induced syncope should be restricted from all competitive athletics until evaluated by a qualified medical professional.
Athletes with syncope should be evaluated with a history, physical examination, ECG, and selective use of other diagnostic tests when there is suspicion of structural heart disease or primary electrical abnormalities that may predispose to recurrent syncope or sudden