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Even watching the World Cup has heart risks

ESC Congress News 2015 - London

During the last three FIFA World Cups football fans experienced abrupt increases in heart rate comparable to that achieved during maximal treadmill exercise testing. Such heart rate changes, suggest French investigators, could be sufficient to increase the risk of cardiovascular events in vulnerable spectators.

Risk Factors, Epidemiology, Rehabilitation and Sports Cardiology


Fabrice Demoniere, from the University Hospital of Fort de France, recalls how he was first drawn to the phenomenon when his own aunt experienced palpitations during the France vs Brazil penalty shootout of the 1986 World Cup. When Demoniere was later analysing 24-hour ECGs for a cardiovascular rehabilitation unit he observed that average heart rates were higher on Saturdays and Sundays, when people watched football or rugby.

For the study reported here in London, 102 football spectators, aged between 18 and 64 years who supported 25 different football teams at the World Cup, were fitted with 24-hour ECG monitoring devices measuring heart rate, supraventricular and ventricular extra-beats and other arrhythmias and sinus node variability during matches. Measurements were taken at the 2006 World Cup in Germany (n = 22), 2010 World Cup in South Africa (n = 30), and 2014 World Cup in Brazil (n = 50).

In addition ‘scores of passion’ were assessed (on a scale of 0 = never, 3 = always): on whether subjects had trouble concentrating during the day their team played; found it hard to recover emotionally when their team lost; would skip work or miss important family events to see a game; and whether they ever felt their heart beating faster during a game.

Results showed that average heart rates significantly increased during matches, with a mean change of 30 beats per minute (p=0.02). Furthermore, in 80% of subjects heart rate reached 95% or more of their maximum heart rate. Indeed, for all three World Cups the average maximal heart rate increased through the first round, quarter final, semi-final and was highest in the final. In the 2014 World Cup in Brazil, for example, average peak heart rates were 146/minute (78% of maximum) in the first round; 168 (88% of maximum) in the quarter final; 169 (86% of maximum) in semi-final; and 182 (92% of maximum) in the final.

In a bivariate analysis investigators found goals, faults, supported team’s victory or defeat, and higher ‘scores of passion’ were all positively associated with average of maximal peak of heart rate during matches and with cardiac events. Supraventricular ectopic beats and paroxysmal atrial fibrillations were observed in 10 subjects (9.8%).

‘Such heart rate changes are likely to have an adverse effect on people with known or undetected cardiac disease,’ says Demoniere. ‘For supporters with known cardiac disease it’s important to take beta blockers before a match to prevent heart rate variability and avoid alcohol and cigarette consumption.’ He added that the results underline the importance of having defibrillators available throughout the soccer stadium.

Programme number 1670: Abrupt changes in heart rate of supporters during FIFA world cups