The Significance of Early Repolarization and Incomplete Right Bundle Block in Athletes

Abstract

Background: Sudden death in athletes is a major concern; the predictors remain to be settled. The significance of early repolarization is the subject of this work. Methods: The study included hundred persons engaged in competitive sports for duration not less than 6 months; with training at least 3 days per week and at least two hours per day. All were males. Full history especially questioning for syncope, tachycardias or chest pain was obtained as well as family history of sudden death or coronary disease. ECG was done for all plus echo Doppler in some cases. Early repolarization was accepted present if J point is elevated more than one mm in LII, III, aVF or in chest leads, with or without raised ST > 1 mm. RV conduction disturbance was considered present if there is Rsr’ or bifid R. 54 played isotonic sport while 46 were on isometric sport. Types of sports: 46 isometric (static) (body builders). Isotonic (dynamic) 54 (Bicycling 6, Football 15, Tennis 3, Basketball 16, Volleyball 8, Swimming 4, Boxing 2). Results: Early repolarization was found in 5 and Rsr’ were present in 14 subjects, (2 had both). None was diagnosed as Brugada or RV dysplasia. Echo was done in 15 who showed ECG increased voltage, increase in LV size was found in 5 (Diastolic diameter up to 61 mm). 10 persons were re-examined after months, no abnormal events were found. Follow up by telephone was up to one year. No one reported tachyarrhythmia or syncope neither before recruitment in the study (retrospective) or after follow-up (prospective). Conclusion: Early repolarization and RV conduction disturbance in athletes apparently did not prove to be hazardous. Further studies are needed.