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
Read the corresponding case report:
Daniel Phillips, et al.
European Heart Journal – Case reports, May 2020, https://doi.org/10.1093/ehjcr/ytab186
Interested in learning more? Access the ESC e-Learning Platform and discover the EAPC Sports Cardiology online courses.
EAPC online educational courses are only accessible to EAPC Ivory, Silver and Gold Members. Not yet an EAPC Member?
Note: The views and opinions expressed on this page are those of the author and may not be accepted by others. While every attempt is made to keep the information up to date, there is always going to be a lag in updating information. The reader is encouraged to read this in conjunction with appropriate ESC Guidelines. The material on this page is for educational purposes and is not for use as a definitive management strategy in the care of patients. Quiz material on the site are only examples and do not guarantee outcomes from formal examinations.