Electroanatomic mapping in athletes: Why and when. An expert opinion paper from the Italian Society of Sports Cardiology

Russo, Antonio Dello; Compagnucci, Paolo; Zorzi, Alessandro; Castelletti, Silvia; Contursi, Maurizio; D'Aleo, Antonio; D’Ascenzi, Flavio; Mos, Lucio; Palmieri, Vincenzo; Patrizi, Giampiero; Pelliccia, Antonio; Sarto, Patrizio; Delise, Pietro; Zeppilli, Paolo; Romano, Silvio; Palamà, Zefferino; Sciarra, Luigi

doi:10.1016/j.ijcard.2023.05.013

Cited by 7 publications

(2 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Miller et al [ 38 ] suggested performing EPS for risk stratification in patients with multiple phenotypic risk factors, such as the evidence of a trigger (pleomorphic PVCs) and substrate (CMR-proven myocardial fibrosis) for SCD. If carried out, a standard PVS protocol should be used, including up to three extra-stimuli from two different sites (right ventricular apex and right ventricular outflow tract) down to effective refractory period (ERP) or 200 ms [ 5 ]; the use of isoproterenol to increase the diagnostic yield of the test is currently not supported by the available literature [ 93 ]. The induction of polymorphic VT and VF with aggressive stimulation protocols (with three extra-stimuli) is a nonspecific finding and may not predict the future risk of SCD [ 38 ].…”

Section: Phenotypic Characterization and Risk Stratificationmentioning

confidence: 99%

“…In patients with a “positive” EPS (sustained monomorphic VT induction), Miller et al recommended implantation of an implantable cardioverter-defibrillator [ 38 ]. However, in the case of a negative PVS, the negative predictive value is at present uncertain, and the whole clinical picture should be considered for therapeutic decisions and advice concerning sports participation [ 61 , 62 , 93 ].…”

Section: Phenotypic Characterization and Risk Stratificationmentioning

confidence: 99%

See 1 more Smart Citation

Arrhythmic Mitral Valve Prolapse and Sports Activity: Pathophysiology, Risk Stratification, and Sports Eligibility Assessment

Compagnucci,

Selimi,

Cipolletta

et al. 2024

JCM

Self Cite

View full text Add to dashboard Cite

Although mitral valve prolapse (MVP) is the most prevalent valvular abnormality in Western countries and generally carries a good prognosis, a small subset of patients is exposed to a significant risk of malignant ventricular arrhythmias (VAs) and sudden cardiac death (SCD), the so-called arrhythmic MVP (AMVP) syndrome. Recent work has emphasized phenotypical risk features of severe AMVP and clarified its pathophysiology. However, the appropriate assessment and risk stratification of patients with suspected AMVP remains a clinical conundrum, with the possibility of both overestimating and underestimating the risk of malignant VAs, with the inappropriate use of advanced imaging and invasive electrophysiology study on one hand, and the catastrophic occurrence of SCD on the other. Furthermore, the sports eligibility assessment of athletes with AMVP remains ill defined, especially in the grey zone of intermediate arrhythmic risk. The definition, epidemiology, pathophysiology, risk stratification, and treatment of AMVP are covered in the present review. Considering recent guidelines and expert consensus statements, we propose a comprehensive pathway to facilitate appropriate counseling concerning the practice of competitive/leisure-time sports, envisioning shared decision making and the multidisciplinary “sports heart team” evaluation of borderline cases. Our final aim is to encourage an active lifestyle without compromising patients’ safety.

show abstract