ATHLETES HEART - MOST COMMON ELECTROCARDI OGRAPHIC FINDINGS

The morphological and functional cardiac adaptations induced by physic al training may be reflected in several athlete's electrocardiographic variants. Rhythm and heart rate disturbances are the most common find ings, and sinus bradycardia is the most frequent adaptation. Non-speci fic intraventricular conduction delay and incomplete right bundle bran ch block are also frequent, but other bundle branch and fascicular blo cks are extremely rare. While the atrioventricular conduction may be p rolonged, the occurrence of first degree and type I second degree atri oventricular blocks depends on the individual's susceptibility. Advanc ed second and third degree atrioventricular blocks are exceptional, an d when present, the possibility of underlying heart disease must be ex cluded. High QRS voltage is more frequent in male athletes, but its co rrelation with left ventricular hypertrophy is low. The ST segment ele vation in the so called ''early repolarization'' pattern is typical of the athlete's electrocardiogram. Vagotonic or high T wave voltages an d U waves are also frequent when sinus bradycardia is present. Tachyar rhythmias and increased automatism arrhythmias are rare and usually be nign. The increased vagal tone is responsible for the suppression of t he physiological and ectopic pacemakers. While Wolff-Parkinson-White s yndrome per se does not exclude an athlete from sports activity, the r isk of a sudden death makes it mandatory to perform an exhaustive card iac evaluation. We may conclude that no sport; can be considered arrhy thmogenic or as a predisposing factor for malignant ventricular arrhyt hmias.