How to Manage Athletes with Syncope

Cardiology Clinics

Volumn 25, Issue 3, 2007, Pages 457-466

  Link, Mark S ^a   Estes III, N A Mark ^a  

^a TUFTS MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANAMNESIS; ATHLETE; BRADYCARDIA; DEFIBRILLATOR; ELECTROCARDIOGRAM; ELECTROPHYSIOLOGY; EXERCISE; HEART DISEASE; HEART SUPRAVENTRICULAR ARRHYTHMIA; HEART VENTRICLE ARRHYTHMIA; HUMAN; INCIDENCE; PRIORITY JOURNAL; RADIOFREQUENCY ABLATION; REVIEW; SYNCOPE; TILT TABLE TEST;

HUMANS; MASS SCREENING; PREVALENCE; PROGNOSIS; RISK FACTORS; SPORTS; SPORTS MEDICINE; SYNCOPE;

EID: 35349000157     PISSN: 07338651     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.ccl.2007.07.005     Document Type: Review

References (76)

1. Link M.S., Homoud M.K., Wang P.J., et al. Syncope in athletes. Cardiovasc Rev Rep 23 (2002) 625-632
2. Estes III N.A., Link M.S., Cannom D., et al. Report of the NASPE policy conference on arrhythmias and the athlete. J Cardiovasc Electrophysiol 12 (2001) 1208-1219
3. Kramer M.R., Drori Y., and Lev B. Sudden death in young soldiers: high incidence of syncope prior to death. Chest 93 (1988) 345-347
4. Maron B.J., Roberts W.C., McAllister H.A., et al. Sudden death in young athletes. Circulation 62 (1980) 218-229
5. Mitchell J.H., Haskell W., Snell P., et al. Task Force 8: classification of sports. 36th Bethesda Conference: eligibility recommendations for competitive athletes with cardiovascular abnormalities. J Am Coll Cardiol 45 (2005) 1364-1367
6. Murdoch B.D. Loss of consciousness in healthy South African men: incidence, causes and relationship to EEG abnormality. S Afr Med J 57 (1980) 771-774
7. Colivicchi F., Ammirati F., and Santini M. Epidemiology and prognostic implications of syncope in young competing athletes. Eur Heart J 25 (2004) 1749-1753
8. Albert C.M., Mittleman M.A., Chae C.U., et al. Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med 343 (2000) 1355-1361
9. Mittleman M.A., MaClure M., Tofler G.H., et al. Triggering of acute myocardial infarction by heavy physical exertion. N Engl J Med 329 (1993) 1677-1683
10. Corrado D., Basso C., Rizzoli G., et al. Does sports activity enhance the risk of sudden death in adolescents and young adults?. J Am Coll Cardiol 42 (2003) 1959-1963
11. Corrado D., Migliore F., Basso C., et al. Exercise and the risk of sudden cardiac death. Herz 31 (2006) 553-558
12. Tofler G.H. Triggers of sudden cardiac death in the athlete. In: Estes N.A.M., Salem D.N., and Wang P.J. (Eds). Sudden cardiac death in the athlete (1998), Futura Publishing Company, Inc., Armonk (NY) 221-234
13. Thompson P.D. The Cardiovascular risks of exercise. In: Thompson P.D. (Ed). Exercise and sports cardiology (2001), McGraw-Hill, New York 127-145
14. Strickberger S.A., Benson D.W., Biaggioni I., et al. AHA/ACCF Scientific Statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation: in collaboration with the Heart Rhythm Society: endorsed by the American Autonomic Society. Circulation 113 (2006) 316-327
15. Maron B.J. Sudden death in young athletes. N Engl J Med 349 (2003) 1064-1075
16. Maron B.J., and Pelliccia A. The heart of trained athletes: cardiac remodeling and the risks of sports, including sudden death. Circulation 114 (2006) 1633-1644
17. Corrado D., Thiene G., Nava A., et al. Sudden death in young competitive athletes: clinicopathologic correlations in 22 cases. Am J Med 89 (1990) 588-596
18. Pelliccia A., Di Paolo F.M., Corrado D., et al. Evidence for efficacy of the Italian national pre-participation screening programme for identification of hypertrophic cardiomyopathy in competitive athletes. Eur Heart J 27 (2006) 2196-2200
19. Graham Jr. T.P., Driscoll D.J., Gersony W.M., et al. Task Force 2: congenital heart disease. J Am Coll Cardiol 45 (2005) 1326-1333
20. Maron B.J., Estes III N.A., and Link M.S. Task Force 11: Commotio cordis: 36th Bethesda Conference: Eligibility Recommendations for Competitive Athletes With Cardiovascular Abnormalities. J Am Coll Cardiol 45 (2005) 1371-1373
21. Maron B.J., Gohman T.E., Kyle S.B., et al. Clinical profile and spectrum of commotio cordis. JAMA 287 (2002) 1142-1146 18
22. Calkins H., Shyr Y., Frumin H., et al. The value of the clinical history in the differentiation of syncope due to ventricular tachycardia, atrioventricular block, and neurocardiogenic syncope. Am J Med 98 (1995) 365-373
23. Kapoor W.N. Evaluation and outcome of patients with syncope. Medicine (Baltimore) 69 (1990) 160-175
24. Alboni P., Brignole M., Menozzi C., et al. Diagnostic value of history in patients with syncope with or without heart disease. J Am Coll Cardiol 37 (2001) 1921-1928
25. McGovern B.A., and Liberthson R. Arrhythmias induced by exercise in athletes and others. S Afr Med J 86 (1996) C78-C82
26. Sneddon J.F., Scalia G., Ward D.E., et al. Exercise induced vasodepressor syncope. Br Heart J 71 (1994) 554-557
27. Sakaguchi S., Shultz J.J., Remole S.C., et al. Syncope associated with exercise, a manifestation of neurally mediated syncope. Am J Cardiol 75 (1995) 476-481
28. Calkins H., Siefert M., and Morady F. Clinical presentation and long-term follow-up of athletes with exercise-induced vasodepressor syncope. Am Heart J 129 (1995) 1159-1164
29. Kosinski D., Grubb B.P., Kip K., et al. Exercise-induced neurocardiogenic syncope. Am Heart J 132 (1996) 451-452
30. Eichna L.W., Horvath S., and Bean W.B. Post-exertional orthostatic hypotension. Am J Med Sci 213 (1947) 641-654
31. Holtzhausen L.M., and Noakes T.D. The prevalence and significance of post-exercise (postural) hypotension in ultramarathon runners. Med Sci Sports Exerc 27 (1995) 1595-1601
32. Link M.S., Wang P.J., and Estes III N.A. Ventricular arrhythmias in the athlete. Curr Opin Cardiol 16 (2001) 30-39
33. Pelliccia A., Maron B.J., Culasso F., et al. Clinical significance of abnormal electrocardiographic patterns in trained athletes. Circulation 102 (2000) 278-284
34. Serra-Grima R., Estorch M., Carrio I., et al. Marked ventricular repolarization abnormalities in highly trained athletes' electrocardiograms: clinical and prognostic implications. J Am Coll Cardiol 36 (2000) 1310-1316
35. Zehender M., Meinertz T., Keul J., et al. ECG variants and cardiac arrhythmias in athletes: clinical relevance and prognostic importance. Am Heart J 119 (1990) 1378-1391
36. Balady G.J., Cadigan J.B., and Ryan T.J. Electrocardiogram of the athlete: an analysis of 289 professional football players. Am J Cardiol 53 (1984) 1339-1343
37. Oakley C.M. The electrocardiogram in the highly trained athlete. Cardiol Clin 10 (1992) 295-302
38. Wang K., Asinger R., and Hodges M. Electrocardiograms of Wolff-Parkinson-White syndrome simulating other conditions. Am Heart J 132 (1996) 152-155
39. Ott P., and Marcus F.I. Electrocardiographic markers of sudden death. Cardiol Clin 24 (2006) 453-469 x
40. Nasir K., Bomma C., Tandri H., et al. Electrocardiographic features of arrhythmogenic right ventricular dysplasia/cardiomyopathy according to disease severity: a need to broaden diagnostic criteria. Circulation 110 (2004) 1527-1534
41. Zareba W. Genotype-specific ECG patterns in long QT syndrome. J Electrocardiol 39 (2006) S101-S106
42. Moss A.J., and Kass R.S. Long QT syndrome: from channels to cardiac arrhythmias. J Clin Invest 115 (2005) 2018-2024
43. Schwartz P.J., Priori S.G., Spazzolini C., et al. Genotype-phenotype correlation in the long-QT syndrome: gene-specific triggers for life-threatening arrhythmias. Circulation 103 (2001) 89-95
44. Benditt D.G., Ferguson D.W., Grubb B.P., et al. ACC Expert Consensus Document: Tilt table testing for assessing syncope. J Am Coll Cardiol 28 (1996) 263-275
45. Grubb B.P., Temesy-Armos P.N., Samoil D., et al. Tilt table testing in the evaluation and management of athletes with recurrent exercise-induced syncope. Med Sci Sports Exerc 25 (1993) 24-28
46. Grubb B.P. Clinical practice. Neurocardiogenic syncope. N Engl J Med 352 (2005) 1004-1010
47. Link M.S., and Estes III N.A.M. Ventricular arrhythmias. In: Estes N.A.M., Salem D.N., and Wang P.J. (Eds). Sudden cardiac death in the athlete (1998), Futura Publishing Co., Inc., Armonk (NY) 253-275
48. Klein G.J., Bashore T.M., Sellers T.D., et al. Ventricular fibrillation in the Wolff-Parkinson-White Syndrome. N Engl J Med 301 (1979) 1080-1085
49. Leitch J.W., Klein G.J., Yee R., et al. Prognostic value of electrophysiologic testing in asymptomatic patients with Wolff-Parkinson-White pattern. Circulation 82 (1990) 1718-1723
50. Pappone C., and Santinelli V. Should catheter ablation be performed in asymptomatic patients with Wolff-Parkinson-White syndrome? Catheter ablation should be performed in asymptomatic patients with Wolff-Parkinson-White syndrome. Circulation 112 (2005) 2207-2215 [discussion: 2216]
51. Wellens H.J. Should catheter ablation be performed in asymptomatic patients with Wolff-Parkinson-White syndrome? When to perform catheter ablation in asymptomatic patients with a Wolff-Parkinson-White electrocardiogram. Circulation 112 (2005) 2201-2207 [discussion: 2216]
52. Brugada P., Green M., Abdollah H., et al. Significance of ventricular arrhythmias initiated by programmed ventricular stimulation: the importance of the type of ventricular arrhythmia induced and the number of premature stimuli required. Circulation 69 (1984) 87-92
53. Bigger J.T., Reiffel J.A., Livelli F.D., et al. Sensitivity, specificity, and reproducibility of programmed ventricular stimulation. Circulation 73 suppl II (1986) II73-II78
54. Prystowsky E.N. Electrophysiologic-electropharmacologic testing in patients with ventricular arrhythmias. Pacing Clin Electrophysiol 11 (1988) 225-251
55. Peters S., and Reil G.H. Risk factors of cardiac arrest in arrhythmogenic right ventricular dysplasia. Eur Heart J 16 (1995) 77-80
56. Corrado D., Leoni L., Calkins H., et al. Prophylactic implantable defibrillator in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia and no prior sustained ventricular tachyarrhythmias: therapy-based risk stratification during a long term follow-up. Circulation (2006) 2006 Annual Scientific Sessions
57. Link M.S., Homoud M.K., Wang P.J., et al. Cardiac arrhythmias in the athlete: the evolving role of electrophysiology. Curr Sports Med Rep 1 (2002) 75-85
58. Grubb B.P., Kanjwal Y., and Kosinski D.J. The postural tachycardia syndrome: a concise guide to diagnosis and management. J Cardiovasc Electrophysiol 17 (2006) 108-112
59. Grubb B.P., Kosinski D.J., and Kanjwal Y. Orthostatic hypotension: causes, classification, and treatment. Pacing Clin Electrophysiol 26 (2003) 892-901
60. DiGirolamo E., Di Iorio C., Leonzio L., et al. Usefulness of a tilt training program for the prevention of refractory neurocardiogenic syncope in adolescents: a controlled study. Circulation 100 (1999) 1798-1801
61. Trim G.M., Krahn A.D., Klein G.J., et al. Pacing for vasovagal syncope after the second Vasovagal Pacemaker Study (VPS II): a matter of judgement. Card Electrophysiol Rev 7 (2003) 416-420
62. Zipes D.P., Ackerman M.J., Estes III N.A.M., et al. Task Force 7: arrhythmias. 36th Bethesda Conference: eligibility recommendations for competitive athletes with cardiovascular abnormalities. J Am Coll Cardiol 45 (2005) 43-52
63. Stevenson W.G. Catheter ablation of monomorphic ventricular tachycardia. Curr Opin Cardiol 20 (2005) 42-47
64. Maron B.J., Shen W.K., Link M.S., et al. Efficacy of the implantable cardioverter-defibrillator for the prevention of sudden death in patients with hypertrophic cardiomyopathy. N Engl J Med 342 (2000) 365-373
65. Maron B.J., Ackerman M.J., Nishimura R.A., et al. Task Force 4: HCM and other cardiomyopathies, mitral valve prolapse, myocarditis, and Marfan syndrome. 36th Bethesda Conference: Eligibility Recommendations for Competitive Athletes With Cardiovascular Abnormalities. J Am Coll Cardiol 45 (2005) 1340-1345
66. Corrado D., Basso C., Thiene G., et al. Spectrum of clinicopathologic manifestations of arrhythmogenic right ventricular cardiomyopathy/dysplasia: a multicenter study. J Am Coll Cardiol 30 (1997) 1512-1520
67. Shoda M., Kasanuki H., Ohnishi S., et al. Recurrence of new ventricular tachycardia after successful catheter ablation in patients with arrhythmogenic right ventricular dysplasia. Circulation 86 (1992) I-580
68. Corrado D., Leoni L., Link M.S., et al. Implantable cardioverter-defibrillator therapy for prevention of sudden death in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia. Circulation 108 (2003) 3084-3091
69. Moss A.J., Zareba W., Hall W.J., et al. Effectiveness and limitations of beta-blocker therapy in congenital long-QT syndrome. Circulation 101 (2000) 616-623
70. Hobbs J.B., Peterson D.R., Moss A.J., et al. Risk of aborted cardiac arrest or sudden cardiac death during adolescence in the long-QT syndrome. JAMA 296 (2006) 1249-1254
71. Sauer A.J., Moss A.J., McNitt S., et al. Long QT syndrome in adults. J Am Coll Cardiol 49 (2007) 329-337
72. Kadish A., Dyer A., Daubert J.P., et al. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. N Engl J Med 350 (2004) 2151-2158
73. Bardy G.H., Lee K.L., Mark D.B., et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med 352 (2005) 225-237
74. AVID Investigators. A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N Engl J Med 337 (1997) 1576-1583
75. Moss A.J., Zareba W., Hall W.J., et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 346 (2002) 877-883
76. Antzelevitch C., Brugada P., Borggrefe M., et al. Brugada syndrome: report of the second consensus conference: endorsed by the Heart Rhythm Society and the European Heart Rhythm Association. Circulation 111 (2005) 659-670