A brief period of deconditioning in athletes with heartbeat irregularities, or "arrhythmias," may help trainers and doctors identify athletes who should stop training and those who may safely re-enter competition, according to the findings of a new study.

Athletes with arrhythmias, but without heart-related abnormalities, who have fewer arrhythmia episodes and show no signs of heart attack or any other heart-related events, may be able to safely resume their training. In such cases, the arrhythmia may just be another sign of "athlete's heart," an enlarged heart that many athletes develop as a result of intense training.

In athletes with heart disease, a deconditioning period that reduces the occurrence of arrhythmias may consequently also reduce the risk of sudden death.

These findings are "good news for athletes," lead study author Dr. Alessandro Biffi, of the Italian Olympic Committee in Rome, told Reuters Health. "The reduction of arrhythmias with detraining favors the concept that these arrhythmias are related to physical conditioning and, therefore, to the athlete's heart syndrome."

In a previous study, Biffi and his team reported that intense athletic training may be associated with ventricular tachyarrhythmias, which are characterized by a dangerously rapid heart rate that can lead to sudden death.

In the current study Biffi and his team investigated whether a period of deconditioning might help alleviate this disturbance in normal heart rhythm.

The researchers performed echocardiograms, a recording of the electrical activity of the heart, on 70 trained athletes who had been advised to discontinue athletic competition because of their irregular heartbeat. These men and women who played soccer, basketball, volleyball and other sports, ranged in age, from 15 to 33 years, and in athletic achievement, with some participating in the Olympic Games or World Championships.

After about 19 weeks of deconditioning, during which time the athletes stopped training and playing sports on a competitive level, 50 of the study participants had a substantial decrease in arrhythmias, and most of them (37 subjects) were able to resume their participation in competitive sports without any restrictions, Biffi and his team report in the Journal of the American College of Cardiology.

"We didn't think that a brief physical deconditioning could induce a so marked reduction in ventricular arrhythmias," Biffi said.

Six athletes who had heart-related abnormalities were also allowed to resume their participation in competitive sports.

Twenty-seven athletes were permanently disqualified from competing, however, due to various cardiovascular conditions.

There were no deaths over an average 8-year follow-up period, study findings indicate.

"A decrease in ventricular arrhythmias produced by detraining may further support the safety of allowing a return to athletics," Drs. Kyoko Soejima and William G. Stevenson write in a related editorial.

However, the Harvard Medical School-based physicians caution that a decrease in arrhythmia "does not exclude the possibility of underlying heart disease," as was observed in a few of the athletes involved in Biffi's study.

SOURCE: Journal of the American College of Cardiology, September 1, 2004.

Reference Source 89
September 1, 2004

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