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MEDICINA DELLO SPORT
A Journal on Sports Medicine
Official Journal of the Italian Sports Medicine Federation
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,163
Medicina dello Sport 1998 March;51(1):53-62
A new cardioarrhythmic classification to grant the agonistic certificate
Tamburrini L. R., Benedetti M.
Scuola di Specializzazione in Medicina dello Sport, II Cattedra di Geriatria e Gerontologia, Università degli Studi di Trieste, Trieste
The authors present a cardioarrhythmic classification, considering organic cardiopathies (primitive and secondary) and functional cardiopathies (primitive and iatrogenic).
In their opinion, this classification is simple but also thorough, as it includes all the different arrhythmic situations young or old athletes can encounter.
This classification is half way between the one Furlanello and Bertoldi conceived (benign arrhythmia, borderline, paraphysiologic and pathologic) and COCIS protocols, that emphasize how the cardiocirculatory system is engaged and tend, therefore, only towards a certifying standard.
Such a complete classification inables the doctor to be sure when granting an agonistic certificate, because arrhythmias, secondary to organic cardiopathies exclude this possibility, whereas functional cardiopathies don’t.
The study on the clinical cases underlines the qualities of this classification. The authors describe the clinical cases using their new classification, in order to describe it’s clinical value.
Primitive organic arrhythmias: 5 cases of ventricular pre-excitation, similar to WPW (3 common B types, 2 rare A types).
Secondary organic arrhythmias: 3 cases of ventricular hyperkinetic arrhythmias (a right arrhythmogenic ventricle, a mitralic prolapse of both valvular leaflets and a case of AIC ostium II). Connected to these syndromes the authors found respectively: a complicated situation of polymorphic EVB (9% of the total ventricular complexes in a day) originating from a double focus; an upperventricular hyperkinetic tachyarrhythmia and a simple tachycardia, originating from the sinuatrial node and pointing backwards; a clockwise rotation on the frontal plane and ventricular repolarization disorders.
Primitive functional arrhythmias: 3 cases of mixed sinuatrial bradycardia and tachycardia, EVB and ESB (1% a wandering pace-maker).
Functional iatrogenic arrhythmias: this group includes a young athlete suffering from atrial-ventricular blocks of I and II grade with Luciani Wenkenbach’s periodism and with both Mobitz’s variations.
This situation is probably due to the fact that the young athlete begun the sport’s activity at an early age and then trained too intensely. In this group the trainer represents the iatrogenic element.