Supraventricular tachycardia in an athlete diagnosed by smartphone ECG: a case report

The case

A 17-year-old semi-professional rugby player was referred to our institution with recurrent episodes of sudden onset, rapid, regular palpitations during exercise. His last episode had occurred during a training session shortly after commencing exercise. There was no history of syncope and no family history of sudden death. This episode eventually terminated after repeated vagal manoeuvres. Echocardiography revealed a structurally normal heart (figure A). There were no arrhythmias during Bruce protocol exercise testing, and several periods of ambulatory heart rhythm monitoring had failed to document any arrhythmias. Ultimately, a smartphone-based ECG recording application was successful in capturing an arrhythmia concurrently with symptoms (figure B).

The athlete’s ECGs