Download - Dr Peter Goethals: Sport en plotse dood - Screening elektrocardiogram (BHC Symposium 2012)
![Page 1: Dr Peter Goethals: Sport en plotse dood - Screening elektrocardiogram (BHC Symposium 2012)](https://reader033.vdocuments.mx/reader033/viewer/2022052901/556db7b6d8b42aed2e8b4807/html5/thumbnails/1.jpg)
SPORT en plotse dood
Screening elektrocardiogram
P. GOETHALS BHC symposium 2012
voor jonge (≤35j) competitiesporters
![Page 2: Dr Peter Goethals: Sport en plotse dood - Screening elektrocardiogram (BHC Symposium 2012)](https://reader033.vdocuments.mx/reader033/viewer/2022052901/556db7b6d8b42aed2e8b4807/html5/thumbnails/2.jpg)
Date of download: 12/3/2012
Copyright © The American College of Cardiology. All rights reserved.
From: Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol. 2003;42(11):1959-1963. doi:10.1016/j.jacc.2003.03.002
Incidence and relative risk (RR) of sudden death (SD) among athletes (solid columns) and non-athletes (open columns) from cardiovascular and non-cardiovascular causes. Athletes had a 2.8 RR of cardiovascular SD (confidence interval [CI] 1.9 to 3.7; p < 0.001), as compared with a 1.7 RR of non-cardiovascular SD (CI 0.3 to 5.7; p = 0.39).
Figure Legend:
![Page 3: Dr Peter Goethals: Sport en plotse dood - Screening elektrocardiogram (BHC Symposium 2012)](https://reader033.vdocuments.mx/reader033/viewer/2022052901/556db7b6d8b42aed2e8b4807/html5/thumbnails/3.jpg)
Distribution of cardiovascular causes of sudden death in 1435 young competitive athletes. From the Minneapolis Heart Institute Foundation Registry, 1980 to 2005
Maron BJ. Circ 2007;115:1643-1655
![Page 4: Dr Peter Goethals: Sport en plotse dood - Screening elektrocardiogram (BHC Symposium 2012)](https://reader033.vdocuments.mx/reader033/viewer/2022052901/556db7b6d8b42aed2e8b4807/html5/thumbnails/4.jpg)
?
Cardiale remodelling: ras, man/vrouw, type sport
Cardiomyopathie
![Page 5: Dr Peter Goethals: Sport en plotse dood - Screening elektrocardiogram (BHC Symposium 2012)](https://reader033.vdocuments.mx/reader033/viewer/2022052901/556db7b6d8b42aed2e8b4807/html5/thumbnails/5.jpg)
Maron B. N Engl J Med 2003;349:1064-1075
Grijze zone: atletenhart of cardiomyopathie?
![Page 6: Dr Peter Goethals: Sport en plotse dood - Screening elektrocardiogram (BHC Symposium 2012)](https://reader033.vdocuments.mx/reader033/viewer/2022052901/556db7b6d8b42aed2e8b4807/html5/thumbnails/6.jpg)
Pre-participation screening? • Doelgroep? Alle sporters (nationaal screeningsprogramma) of
alleen competitiesporters? • Wanneer? • Frequentie? • Protocol ?(anamnese, KO, ECG) • Wie heeft expertise? • Wie betaalt? • Vals negatief ECG resultaat? Marfan syndroom- abnormale
oorsprong kroonslagader- myocarditis… • Een afwijkend ECG, wat nu? • ‘Cost effective’? Lage incidentie 1/50.000 maar veel gewonnen
levensjaren! Ann Intern Med 2010; 152: 276-286
![Page 7: Dr Peter Goethals: Sport en plotse dood - Screening elektrocardiogram (BHC Symposium 2012)](https://reader033.vdocuments.mx/reader033/viewer/2022052901/556db7b6d8b42aed2e8b4807/html5/thumbnails/7.jpg)
0
0,5
1
1,5
2
2,5
3
3,5
4
4,5
1979-1980
1981-1982
1983-1984
1985-1986
1987-1988
1989-1990
1991-1992
1993-1994
1995-1996
1997-1998
1999-2000
2001-2002
2003-2004
Years
Sudd
en d
eath
per
100
000
pers
on-y
ears
Annual Incidence Rates of Sudden Cardiovascular Death in Screened Competitive Athletes and
Unscreened Nonathletes Aged 12 to 35 Years in the Veneto Region of Italy
(1979-2004)
Athletes Nonathletes
P for trend <0.001
Corrado et al JAMA 2006;296:1593-1601
![Page 8: Dr Peter Goethals: Sport en plotse dood - Screening elektrocardiogram (BHC Symposium 2012)](https://reader033.vdocuments.mx/reader033/viewer/2022052901/556db7b6d8b42aed2e8b4807/html5/thumbnails/8.jpg)
GROEP 1 (frequente-trainingsgebonden ECG veranderingen) Eur Heart J 2010; 31: 243-259
Isolated QRS voltage criteria LVH Sinus bradycardie AV blok gr I ORBTB Vroege repolarisatie
1005 elite atleten: 402 (40%) abnormaal ECG 240 atleten (24%) lone QRS LVH
Pelliccia et al Circulation 2000;102: 278-284
![Page 9: Dr Peter Goethals: Sport en plotse dood - Screening elektrocardiogram (BHC Symposium 2012)](https://reader033.vdocuments.mx/reader033/viewer/2022052901/556db7b6d8b42aed2e8b4807/html5/thumbnails/9.jpg)
GROEP 1 (frequente- trainingsgebonden ECG veranderingen) Eur Heart J 2010; 31: 243-259
Isolated QRS voltage criteria LVH Sinus bradycardie AV blok gr I ORBTB Vroege repolarisatie
![Page 10: Dr Peter Goethals: Sport en plotse dood - Screening elektrocardiogram (BHC Symposium 2012)](https://reader033.vdocuments.mx/reader033/viewer/2022052901/556db7b6d8b42aed2e8b4807/html5/thumbnails/10.jpg)
Opsporen van cardiomyopathie door ECG
HCM sens. 95%
ARVC sens.80%
Inversie T golf ST segment depressie Pathologische Q LA hypertrofie QRS as afwijking/LAH/LPH RVH Pre excitatie VLBTB/VRBTB Lang of kort QT interval Brugada like vroege repolarisatie
GROEP 2 (zeldzame-niet trainingsgebonden ECG veranderingen) Eur Heart J 2010; 31: 243-259
Prof Sharma
St George’s
University of London 20/10/2012
![Page 11: Dr Peter Goethals: Sport en plotse dood - Screening elektrocardiogram (BHC Symposium 2012)](https://reader033.vdocuments.mx/reader033/viewer/2022052901/556db7b6d8b42aed2e8b4807/html5/thumbnails/11.jpg)
Screening aanbevolen ESC, IOC, vele Europese sportfederaties
![Page 12: Dr Peter Goethals: Sport en plotse dood - Screening elektrocardiogram (BHC Symposium 2012)](https://reader033.vdocuments.mx/reader033/viewer/2022052901/556db7b6d8b42aed2e8b4807/html5/thumbnails/12.jpg)
BHC vous remercie de votre attention
BHC bedankt U voor uw
aandacht