Objective:

To determine the association between exercise training patterns and the incidence of ventricular arrhythmia in veteran male endurance athletes aged 50 and older, highlighting the importance of athlete health.

Key Findings:

• 55 ventricular arrhythmia events occurred during a median follow-up of 796 days, with 3 cases of VT and 52 cases of NSVT, indicating a significant risk in this population.
• Myocardial fibrosis was significantly more prevalent in athletes with ventricular arrhythmia (76%) compared to those without (38.3%), suggesting a strong link.
• The incidence of exercise-related ventricular arrhythmia was 0.4/1000 h of exercise, while non-exercise-related was 0.01/1000 h, highlighting the risks associated with intense exercise.
• All sustained VT cases occurred during exercise in athletes with fibrosis and were preceded by NSVT, emphasizing the need for monitoring during physical activity.
• No significant differences in training patterns were found between athletes with and without ventricular arrhythmia, suggesting other factors may contribute.

Interpretation:

The study highlights a significant association between myocardial fibrosis and the occurrence of ventricular arrhythmia in older male endurance athletes, suggesting that intense exercise may trigger arrhythmias in those with underlying heart scarring, with implications for athlete health management.

Limitations:

• The study focused only on male endurance athletes, limiting generalizability to other populations.
• The sample size was relatively small, which may affect the robustness of the findings, and potential biases in self-reported data should be considered.

Conclusion:

Myocardial fibrosis may be a critical factor in the development of ventricular arrhythmia during intense exercise in older male endurance athletes, indicating a need for monitoring and potential interventions for this population, as well as further research.