PDF(Pubmed)
Abstract：
The intricate relationship between sports participation and cardiac arrhythmias is a key focus of cardiovascular research. Physical activity, integral to preventing atherosclerotic cardiovascular disease, induces structural, functional, and electrical changes in the heart, potentially triggering arrhythmias, particularly atrial fibrillation (AF). Despite the cardiovascular benefits, the optimal exercise amount remains unclear, revealing a J-shaped association between AF and exercise. Endurance athletes, particularly males, face elevated AF risks, influenced by age. Risk factors vary among sports modalities, with unique physiological responses in swim training potentially elevating AF risk. Clinical management of AF in athletes necessitates a delicate balance between rhythm control, rate control, and anticoagulation therapy. Sport-induced bradyarrhythmias, including sinus bradycardia and conduction disturbances, are prevalent among athletes. Managing bradycardia in athletes proves challenging due to its complex and not fully understood pathophysiology. Careful consideration is required, particularly in symptomatic cases, where pacemaker implantation may be necessary for sinus node dysfunction. Although pacing is recommended for specific atrioventricular (AV) blocks, milder forms often prevail without restricting sports participation. This review explores the nuanced relationship between exercise and tachy- and bradyarrhythmia in athletes, addressing the challenges clinicians face when optimizing patient care in this distinctive population.
摘要：
运动参与与心律失常之间的复杂关系是心血管研究的重点。身体活动,预防动脉粥样硬化性心血管疾病的组成部分，诱导结构，功能，和心脏的电变化，可能引发心律失常,特别是心房颤动（AF）。尽管有心血管益处，最佳运动量尚不清楚，揭示了房颤和运动之间的J形关联。耐力运动员，尤其是男性,面临房颤风险升高，受年龄的影响。风险因素因运动方式而异，游泳训练中独特的生理反应可能会增加房颤风险。运动员房颤的临床管理需要节奏控制之间的微妙平衡，速率控制,抗凝治疗。运动诱发的缓慢性心律失常,包括窦性心动过缓和传导障碍,在运动员中普遍存在。由于其复杂且未完全理解的病理生理学，在运动员中管理心动过缓被证明具有挑战性。需要仔细考虑，特别是在有症状的情况下，窦房结功能障碍可能需要植入起搏器。尽管起搏被推荐用于特定房室传导阻滞,温和的形式往往普遍存在，而不限制体育参与。这篇综述探讨了运动与运动员快速和缓慢性心律失常之间的细微差别。解决临床医生在这一独特人群中优化患者护理时面临的挑战。
