The case
A 17-year-old semi-professional rugby player was referred to our institution with recurrent episodes of sudden onset, rapid, regular palpitations during exercise. His last episode had occurred during a training session shortly after commencing exercise. There was no history of syncope and no family history of sudden death. This episode eventually terminated after repeated vagal manoeuvres. Echocardiography revealed a structurally normal heart (figure A). There were no arrhythmias during Bruce protocol exercise testing, and several periods of ambulatory heart rhythm monitoring had failed to document any arrhythmias. Ultimately, a smartphone-based ECG recording application was successful in capturing an arrhythmia concurrently with symptoms (figure B).
The athlete’s ECGs
Test your knowledge
Case report
Read the corresponding case report:
Arrhythmia in an athlete diagnosed by smartphone electrocardiogram: a case report
Daniel Phillips, et al.
European Heart Journal – Case reports, May 2020, https://doi.org/10.1093/ehjcr/ytab186
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