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Active Voice: Early Repolarization — Significance in Athletes

from By: Philip Aagaard, M.D., Ph.D.

Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily reflect positions or policies of ACSM.

Philip Aagaard is a physician and researcher at Montefiore Medical Center - The University Hospital of Albert Einstein College of Medicine in the Bronx, New York. His research interests include prevention of sudden cardiac death in athletes and the athlete’s ECG.

This commentary presents Dr. Aagaard’s views related to a research report that he and his colleagues authored, which appears in the July 2014 issue of Medicine & Science in Sports & Exercise® (MSSE).


For decades, early repolarization (ER) was considered a benign ECG finding. However, this view was recently challenged by studies associating early repolarization with an increased risk of arrhythmic death in the general population.

Physical training can induce early repolarization, possibly by increasing vagal tone. It is therefore not surprising that early repolarization is prevalent in athletes. In fact, it is even considered a feature of an athlete’s heart. However, in one related study, it was reported that early repolarization was more common in athletes suffering sudden cardiac arrest compared with control athletes. This has sparked debate regarding the significance of early repolarization in the athletic population. more


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