[Ventricular arrhythmia in the athlete: practical management]

The aim of athletic competition is to exceed ones present limits, which exposes the athlete to increased risk is helshe has a cardiac disorder. Ventricular excitability is not part of the athletic heart syndrome, and only the presence of resting ventricular extrasystoles that are monomorphic, ungrouped and disappear with exercise can be considered physiological. Significant ventricular arrhythmia can reflect a cardiac disorder that should be routinely sought in order to determine if there is a potential risk of sudden death favoured by physical effort. The confirmation of arrhythmia and seeking a cardiac disorder require a rigorous approach based on history-taking, clinical examination and initial performance of non-invasive, orienting examinations. Invasive examinations, based on the case, are often required if a disorder is suspected or if there is a question concerning the severity of the arrhythmia. Decisions concerning aptitude for competition are decided case by case, according to the disorder, with reference to the 26th Bethesda Conference. If the ventricular arrhythmia is shown to be benign and no underlying cardiac disorder exists, athletic competition may be pursued without restrictions. In case of contrary findings, physical activity will be limited and the authorized level will be precisely determined according to the context and the results of exertion tests made during treatment.