Electrocardiographic manifestations of inherited heart diseases – a sports cardiologist’s point of view. Part 2. Ion channel diseases
1 Laboratory of Sports Cardiology at the Department of Paediatrics, Preventive Cardiology and Immunology of Developmental Age, Medical University of Łódź, Poland. Head of the Laboratory: Zbigniew Krenc, MD, PhD, Head of the Department: Professor Krzysztof Zeman, MD, PhD
2 Department of Paediatrics, Immunology and Nephrology, Polish Mother’s Memorial Hospital – Research Institute, Łódź, Poland. Head of the Department: Professor Krzysztof Zeman, MD, PhD Correspondence: Zbigniew Krenc, MD, PhD, Department of Paediatrics, Preventive Cardiology and Immunology of Developmental Age, Medical University, Institute of the Polish Mother’s Health Centre,
Rzgowska 281/289, 93-338 Łódź, Poland, tel.: +48 504 221 512, e-mail: firstname.lastname@example.org
Physical activity is associated with an increased risk of sudden death for individuals with an undiagnosed cardiovascular disease. Medical evaluations, including a resting electrocardiogram, conducted before and during physical training, enable the identification of still asymptomatic athletes with life-threatening heart diseases and help to protect them from sudden cardiac death. The incidence of sudden cardiac death is estimated at two cases for each 100,000 young athletes per year and it is 2–4 times higher when compared with non-athletes. The most common causes of sudden cardiac death in athletes younger than 35 are cardiomyopathies: hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy. Three to four per cent of young athletes who die suddenly have no evidence of a structural heart disease, and the cause of their cardiac arrest is primarily electrical heart diseases, such as inherited cardiac ion channel defects (channelopathies), including long and short QT syndromes, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia. The clinical courses of all these channelopathies are highly varied. They can be asymptomatic. In certain cases, episodic syncope or aborted cardiac arrest can occur. Sudden cardiac death, especially during physical exercise, can be the first sign. The aim of this article was to provide some information helpful in the recognition of electrocardiographic changes in genetic ion channel diseases, especially in the context of the prevention of sudden cardiac events in young athletes.