运动员心房颤动的初步观察

PRELIMINARY STUDY OF ATRIAL FIBRILLATION IN ATHLETES

作者对经心电图证实出现过心房颤动的运动员29例(其中青年运动员9例,已停止训练的老运动员20例)进行了临床和随访观察。就其发病、病因、诱因、临床表现及训练安排等作初步探讨。结果表明运动员中心房颤动不一定是非常严重的心律失常,有时只影响参加激烈运动,但即使心房颤动是唯一异常,其病理意义仍不容忽视。

29 athletes, male 28, female 1, age at initial visit 21-70 years, with atrial fibrillation confirmed byECG were studied. The clinical impressions were as follows: idiopathic atrial fibrillation 19 cases, possiblecoronary heart disease 7, hyperthyroid cardiopathy 1, possible sick sinus syndrome 1 and sudden death in 1case. The bodily exertion, intense working and emotional instability were the main predisposing causes andcold, taking food and drinking alcohol were less important factors and in a few subjects no definite predis-posing causes could be found. The series of ECG showed paroxymal atrial fibrillation in 26 out of the 29cases and 3 with chronic atrial fibrillation. The ventricular rate in the presence of atrial fibrillation, in mostof the athletes, were relatively low, below 100 beats/min in 23 cases. The symptoms were palpitation, dys-pnea, chest distress and weakness etc, mostly were not serious and some were asymptomatic. During follow-up we have found that majority of the athletes could not participate in the sports training program regularlyand all but one could work and lead an active life, one coach died suddenly. The atrial fibrillation need not to be a very serious arrhythmia in athletes, sometimes the handicap isdemonstrable only on strenuous exercise, but the pathologic significance should not be neglected even if theatrial fibrillation is the only abnormality present.