Ventricular tachyarrhythmias

The identification of ventricular arrhythmias in athletes should always be carefully considered because of the increased risk of SCD. The main factor determining this risk is the presence of an underlying structural or primary arrhythmic heart disease. Consequently, the identification of ventricular arrhythmias in an athlete should prompt exploratory testing, most commonly involving 24-hour Holter ECG, echocardiography, and an exercise test. Other tests should be considered on an individual basis. In general, the more frequent and complex the ventricular arrhythmias, the higher are the risks of a heart disease, and a more thorough examination is required. While most arrhythmias in athletes without heart disease are idiopathic ventricular arrhythmias, considerable attention has been paid recently to an exercise-induced substrate for ventricular arrhythmias, similar to classic forms of arrhythmogenic ventricular cardiomyopathy. Overall, the identification of a cardiac condition will determine the prognosis, therapeutic approach, and eligibility for competitive sport.