Evaluation of Early Repolarization Pattern in Male Teenage Competitive Athletes and Association With Left Ventricular Remodeling

Abstract

Objective: Early repolarization pattern (ERP) on electrocardiogram is more common among young athletes than in the general population, and has been considered a benign finding. However, ERP has been associated with increased risk of sudden cardiac death. The objectives of this study were to evaluate ERP in teenage athletes; investigate associations between ERP and echocardiographic findings of the left ventricle (LV); and to describe the impact of different sports disciplines on ERP. Methods: ERP was assessed in male teenage athletes from sports institutions for 5 different types of sport--basketball, swimming, football, wrestling, and tennis. All had been training for at least 3 hours per week for over at least 2 years. ERP was defined as J-point elevation >= 1 mV in 2 contiguous and/or lateral leads. A conventional echocardiography was performed in all athletes. Results: ERP was evaluated in 159 athletes with a mean age of 14 (range 10-18 years). It was more common in those training with combined exercise. There was no association between ERP and echocardiographic findings of left ventricular remodeling and geometric pattern. Conclusion: ERP is a frequent finding among teenage athletes. However, frequency varies by sports type, being more common in those training with combined exercise. It is not associated with structural echocardiographic alterations and is primarily seen as an electrophysiological change.