Amateur Athlete with Sinus Arrest and Severe Bradycardia Diagnosed through a Heart Rate Monitor: A Six-Year Observation—The Necessity of Shared Decision-Making in Heart Rhythm Therapy Management

Robert Gajda (), Beat Knechtle, Anita Gębska-Kuczerowska, Jacek Gajda, Sebastian Stec, Michalina Krych, Magdalena Kwaśniewska and Wojciech Drygas
Additional contact information
Robert Gajda: Center for Sports Cardiology, Gajda-Med Medical Center, ul. Piotra Skargi 23/29, 06-100 Pułtusk, Poland
Beat Knechtle: Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland
Anita Gębska-Kuczerowska: Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, Kazimierza Wóycickiego 1/3, 01-938 Warsaw, Poland
Jacek Gajda: Center for Sports Cardiology, Gajda-Med Medical Center, ul. Piotra Skargi 23/29, 06-100 Pułtusk, Poland
Sebastian Stec: Division of Electrophysiology, Cardioneuroablation, Catheter Ablation and Cardiac Stimulation, Subcarpathian Center for Cardiovascular Intervention, 38-500 Sanok, Poland
Michalina Krych: Department of Congenital Heart Diseases, The Cardinal Stefan Wyszyński National Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland
Magdalena Kwaśniewska: Department of Preventive Medicine, Faculty of Health, Medical University of Lodz, ul. Lucjana Żeligowskiego 7/9, 90-752 Łódź, Poland
Wojciech Drygas: Department of Congenital Heart Diseases, The Cardinal Stefan Wyszyński National Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland

IJERPH, 2022, vol. 19, issue 16, 1-17

Abstract: Heart rate monitors (HRMs) are used by millions of athletes worldwide to monitor exercise intensity and heart rate (HR) during training. This case report presents a 34-year-old male amateur soccer player with severe bradycardia who accidentally identified numerous pauses of over 4 s (maximum length: 7.3 s) during sleep on his own HRM with a heart rate variability (HRV) function. Simultaneous HRM and Holter ECG recordings were performed in an outpatient clinic, finding consistent 6.3 s sinus arrests (SA) with bradycardia of 33 beats/min. During the patient’s hospitalization for a transient ischemic attack, the longest pauses on the Holter ECG were recorded, and he was suggested to undergo pacemaker implantation. He then reduced the volume/intensity of exercise for 4 years. Afterward, he spent 2 years without any regular training due to depression. After these 6 years, another Holter ECG test was performed in our center, not confirming the aforementioned disturbances and showing a tendency to tachycardia. The significant SA was resolved after a period of detraining. The case indicates that considering invasive therapy was unreasonable, and patient-centered care and shared decision-making play a key role in cardiac pacing therapy. In addition, some sports HRM with an HRV function can help diagnose bradyarrhythmia, both in professional and amateur athletes.

Keywords: bradyarrhythmia; block S-A; heart rate monitors; heart rate variability; leisure time activity; athlete’s heart; pacing therapy; shared decision-making; cardioneuroablation; deconditioning (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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