Int J Arrhythm.  2021 Mar;22(1):3. 10.1186/s42444-021-00031-1.

Ventricular late potentials measured by signal‑averaged electrocardiogram in young professional soccer players

• Lee J
• Chung H
• Kim H
• Woo J
• Kim S
• Kim W
• Kim W
• Kim J

• KMID: 2514537
• DOI: http://doi.org/10.1186/s42444-021-00031-1

Abstract

Background and objectives
Athlete’s heart is characterized by structural cardiac changes, including enlargement and hypertrophy. However, exercise-induced cardiac electrical remodeling is not well known in Asian athletes. We sought to evaluate the association between vigorous exercise and the development of abnormal late potential on signal-averaged electrocardiogram (SAECG). Method: We analyzed 48 Korean professional soccer players and 71 healthy sedentary controls who underwent SAECG and transthoracic echocardiography at Kyung Hee University Hospital. An SAECG was considered abnormal (positive for ventricular late potential) when any one of the three following criteria was met: filtered QRS dura‑ tion > 114 ms, root-mean-square voltage in the terminal 40 ms < 20 uV, or a voltage < 40 uV for more than 38 ms.
Results
Fragmented QRS was more commonly found in athletes (1.4% vs. 10.4%). Athletes demonstrated signifi‑ cantly higher proportion of filtered QRS duration > 114 ms (7.0% vs. 22.9%, P = 0.013) and lower terminal QRS rootmean-square voltage < 20 uV (5.6% vs. 20.8%, P = 0.012). Ventricular late potential on SAECG was significantly more frequent in athletes (15.5% vs. 35.4%, P = 0.012). Regarding echocardiographic parameters, the athletes had larger cardiac chamber size; however, these differences became non-significant after adjustment for body surface area, except left ventricular mass index (65.7 ± 12.7 g/m² vs. 84.7 ± 17.7 g/m² , P < 0.001).
Conclusion
Abnormal SAECG findings were significantly more common in athletes than in controls. Further study is needed to determine the clinical impact of these abnormal SAECGs in athletes and cardiac outcomes in the long term.

Keyword

Electrocardiography; Athlete’s heart syndrome; Signal-averaged electrocardiography