Differentiating between ECG patterns related to athletes' heart remodeling and pathological findings is a challenge in sports cardiology. As the significance of fragmented complex in athletes remains uncertain, this study aimed to assess the presence of fragmented QRS in lead V₁ (fQRSV₁) among young athletes and its association with heart adaptations and arrhythmias. Young athletes referred for annual pre-participation screening receiving a maximal exercise testing and transthoracic echocardiography from January 2015 to March 2021 were included. The study included 684 young athletes. The prevalence of fQRSV₁ was 33%. Subjects with fQRSV₁ had higher exercise capacity and indexes of right ventricular function and remodeling. Among highly trained athletes, the fQRSV₁ group demonstrated also increased left ventricular wall thickness. No significant association existed between fQRSV₁ and exercise-induced arrhythmias, even in highly trained athletes. The high prevalence of fQRSV₁ in young athletes is associated with training-induced heart adaptations but not exercise-induced ventricular arrhythmias.

Graphical Abstract

The fragmented QRS complex in lead V₁ in young athletes. PPS = preparticipation screening; EST = exercise stress test; fQRSV₁ = fragmented QRS in lead V₁; PSBs = premature supraventricular beats; PVBs = premature ventricular beats.

中文翻译：

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V1 导联中破碎的 QRS 波群：是时候更新运动员的心电图了？

区分与运动员心脏重塑相关的心电图模式和病理结果是运动心脏病学中的一个挑战。由于片段化复合波对运动员的重要性仍不确定，本研究旨在评估年轻运动员 V ₁导联(fQRSV ₁ ) 中片段化 QRS 的存在及其与心脏适应和心律失常的关系。2015 年 1 月至 2021 年 3 月期间，每年接受最大运动测试和经胸超声心动图检查的年轻运动员也被纳入其中。该研究包括 684 名年轻运动员。_{fQRSV 1}的患病率为33%。_{fQRSV 1}的受试者具有较高的运动能力以及右心室功能和重构指数。在训练有素的运动员中，fQRSV ₁组的左心室壁厚度也有所增加。即使在训练有素的运动员中，fQRSV _{1与运动诱发的心律失常之间也不存在显着关联。年轻运动员中 fQRSV 1}的高患病率与训练引起的心脏适应有关，但与运动引起的室性心律失常无关。

图形概要

年轻运动员V ₁导联中的支离破碎的 QRS 波群。PPS = 参与前筛选；EST=运动压力测试；fQRSV _{1 = V 1} 导联中的碎片 QRS ；PSBs = 室上性早搏；PVB = 室性早搏。