Ventricular ectopy in athletes

Ventricular ectopic beats (VEBs) have been described in approximately 1% of clinically normal persons as detected by standard electrocardiogram (ECG) (1), and in 40% to 75% of apparently healthy persons as detected by 24 to 48 h of continuous ambulatory (Holter) ECG (2–5). Both the incidence and the frequency of VEBs increase with age (2,5), and even frequent ( 60/h or 1/min) and complex (involving multiform, alternating or repetitive patterns or R on T beats) VEBs occur in apparently healthy subjects (5–9). Such individuals constitute an estimated prevalence of 1% to 4% of the general population (6). Nevertheless, VEBs in apparently healthy persons have been the genesis of concern and anxiety to both patients and physicians ever since the earliest reports of an irregular pulse. This is particularly true when such ventricular ectopy is either frequent and/or complex, because the latter arrhythmias identify a subset of patients in cardiovascular disease populations at increased risk of death and sudden cardiac death (10–12). Never is physician concern more heightened as