An asymptomatic athlete with-pre-excitation

14 January 2015

Organised by:

The case

Description

A 16-year-old Caucasian international level cyclist underwent pre-participation cardiac screening.
He reported no sinister cardiac symptoms or family history of heart disease or sudden cardiac death at a young age. Physical Examination was unremarkable.

His 12 lead ECG is presented below.

References

[*1] Recommendations for interpretation of 12-lead electrocardiogram in the athlete.
Corrado D, Pelliccia A, Heidbuchel H, Eur Heart J. 2010;31:243-259
[*2] Development and validation of an ECG algorithm for identifying accessory pathway ablation site in Wolff-Parkinson-White syndrome.
Arruda MS, McClelland JH, Wang X, Beckman KJ, Widman LE, Gonzalez MD, Nakagawa H, Lazzara R, Jackman WM. J Cardiovasc Electrophysiol. 1998;9:2-12.
[*3] Evaluation and management of Wolff-Parkinson-White in athletes.
Rao AL, Salerno JC, Asif IM, Drezner J. Sports Health. 2014;6:326-32.
[*4] Recommendations for competitive sports participation in athletes with cardiovascular disease: a consensus document from the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology.
Pelliccia A, Fagard R, Bjørnstad HH, et al.Eur Heart J. 2005;26:1422-45
[*5] 36th Bethesda Conference: eligibility recommendations for competitive athletes with cardiovascular abnormalities.
Maron BJ, Zipes DP. J Am Coll Cardiol 2005;45:2–64.
[*6] PACES/HRS expert consensus statement on the management of the asymptomatic young patient with a Wolff-Parkinson-White (WPW, ventricular pre-excitation) electrocardiographic pattern: developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology Foundation (ACCF), the American Heart Association (AHA), the American Academy of Pediatrics (AAP), and the Canadian Heart Rhythm Society (CHRS).
Cohen MI, Triedman JK,Cannon BC et al. Heart Rhythm. 2012;9:1006–1024

Notes to editor

Dr Harshil Dhutia, Registrar in Cardiology, St George’s university of London
Dr Michael Papadakis, Lecturer in cardiology, St George’s university of London
Prof Sanjay Sharma, Professor of clinical cardiology, St George’s university of London