Differences in Arrhythmia Detection Between Harvard Step Test and Maximal Exercise Testing in a Paediatric Sports Population
BACKGROUND: Sport practice may elevate the risk of cardiovascular events, including sudden cardiac death, in athletes with undiagnosed heart conditions. In Italy, pre-participation screening includes a resting ECG and either the Harvard Step Test (HST) or maximal exercise testing (MET), but the rela...
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MDPI AG
2025-01-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/12/1/22 |
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| author | Massimiliano Bianco Fabrizio Sollazzo Riccardo Pella Saverio Vicentini Samuele Ciaffoni Gloria Modica Riccardo Monti Michela Cammarano Paolo Zeppilli Vincenzo Palmieri |
| author_facet | Massimiliano Bianco Fabrizio Sollazzo Riccardo Pella Saverio Vicentini Samuele Ciaffoni Gloria Modica Riccardo Monti Michela Cammarano Paolo Zeppilli Vincenzo Palmieri |
| author_sort | Massimiliano Bianco |
| collection | DOAJ |
| description | BACKGROUND: Sport practice may elevate the risk of cardiovascular events, including sudden cardiac death, in athletes with undiagnosed heart conditions. In Italy, pre-participation screening includes a resting ECG and either the Harvard Step Test (HST) or maximal exercise testing (MET), but the relative efficacy of the latter two tests for detecting arrhythmias and heart conditions remains unclear. METHODS: This study examined 511 paediatric athletes (8–18 years, 76.3% male) without known cardiovascular, renal, or endocrine diseases. All athletes underwent both HST and MET within 30 days. Absolute data and data relative to theoretical peak heart rates, arrhythmias (supraventricular and ventricular) and cardiovascular diagnoses were collected. RESULTS: HST resulted in a lower peak heart rate than MET (181.1 ± 9.8 vs. 187.5 ± 8.1 bpm, <i>p</i> < 0.001), but led to the detection of more supraventricular (18.6% vs. 13.1%, <i>p</i> < 0.001) and ventricular (30.5% vs. 22.7%, <i>p</i> < 0.001) arrhythmias, clustering during recovery (<i>p</i> = 0.014). This pattern was significant in males but not females. Among athletes diagnosed with cardiovascular diseases (22.3%), HST identified more ventricular arrhythmias (26.3% vs. 18.4%, <i>p</i> = 0.05), recovery-phase arrhythmias (20.2% vs. 14.0%, <i>p</i> = 0.035), and polymorphic arrhythmias (6.1% vs. 1.8%, <i>p</i> = 0.025). CONCLUSIONS: HST detects arrhythmias more effectively than MET in young male athletes, especially during recovery. More ventricular arrhythmias were highlighted even in athletes with cardiovascular conditions. |
| format | Article |
| id | doaj-art-baddd6fb0d95400599a4d1504abf42c6 |
| institution | Kabale University |
| issn | 2308-3425 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-baddd6fb0d95400599a4d1504abf42c62025-01-24T13:36:01ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-01-011212210.3390/jcdd12010022Differences in Arrhythmia Detection Between Harvard Step Test and Maximal Exercise Testing in a Paediatric Sports PopulationMassimiliano Bianco0Fabrizio Sollazzo1Riccardo Pella2Saverio Vicentini3Samuele Ciaffoni4Gloria Modica5Riccardo Monti6Michela Cammarano7Paolo Zeppilli8Vincenzo Palmieri9Unità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyUnità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyUnità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyUnità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyUnità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyDipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyUnità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyUnità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyUnità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyUnità Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyBACKGROUND: Sport practice may elevate the risk of cardiovascular events, including sudden cardiac death, in athletes with undiagnosed heart conditions. In Italy, pre-participation screening includes a resting ECG and either the Harvard Step Test (HST) or maximal exercise testing (MET), but the relative efficacy of the latter two tests for detecting arrhythmias and heart conditions remains unclear. METHODS: This study examined 511 paediatric athletes (8–18 years, 76.3% male) without known cardiovascular, renal, or endocrine diseases. All athletes underwent both HST and MET within 30 days. Absolute data and data relative to theoretical peak heart rates, arrhythmias (supraventricular and ventricular) and cardiovascular diagnoses were collected. RESULTS: HST resulted in a lower peak heart rate than MET (181.1 ± 9.8 vs. 187.5 ± 8.1 bpm, <i>p</i> < 0.001), but led to the detection of more supraventricular (18.6% vs. 13.1%, <i>p</i> < 0.001) and ventricular (30.5% vs. 22.7%, <i>p</i> < 0.001) arrhythmias, clustering during recovery (<i>p</i> = 0.014). This pattern was significant in males but not females. Among athletes diagnosed with cardiovascular diseases (22.3%), HST identified more ventricular arrhythmias (26.3% vs. 18.4%, <i>p</i> = 0.05), recovery-phase arrhythmias (20.2% vs. 14.0%, <i>p</i> = 0.035), and polymorphic arrhythmias (6.1% vs. 1.8%, <i>p</i> = 0.025). CONCLUSIONS: HST detects arrhythmias more effectively than MET in young male athletes, especially during recovery. More ventricular arrhythmias were highlighted even in athletes with cardiovascular conditions.https://www.mdpi.com/2308-3425/12/1/22sportarrhythmiaspre-participation screeningyoung athletesstress testtest modes |
| spellingShingle | Massimiliano Bianco Fabrizio Sollazzo Riccardo Pella Saverio Vicentini Samuele Ciaffoni Gloria Modica Riccardo Monti Michela Cammarano Paolo Zeppilli Vincenzo Palmieri Differences in Arrhythmia Detection Between Harvard Step Test and Maximal Exercise Testing in a Paediatric Sports Population Journal of Cardiovascular Development and Disease sport arrhythmias pre-participation screening young athletes stress test test modes |
| title | Differences in Arrhythmia Detection Between Harvard Step Test and Maximal Exercise Testing in a Paediatric Sports Population |
| title_full | Differences in Arrhythmia Detection Between Harvard Step Test and Maximal Exercise Testing in a Paediatric Sports Population |
| title_fullStr | Differences in Arrhythmia Detection Between Harvard Step Test and Maximal Exercise Testing in a Paediatric Sports Population |
| title_full_unstemmed | Differences in Arrhythmia Detection Between Harvard Step Test and Maximal Exercise Testing in a Paediatric Sports Population |
| title_short | Differences in Arrhythmia Detection Between Harvard Step Test and Maximal Exercise Testing in a Paediatric Sports Population |
| title_sort | differences in arrhythmia detection between harvard step test and maximal exercise testing in a paediatric sports population |
| topic | sport arrhythmias pre-participation screening young athletes stress test test modes |
| url | https://www.mdpi.com/2308-3425/12/1/22 |
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