Sports Heart Monitors as Reliable Diagnostic Tools for Training Control and Detecting Arrhythmias in Professional and Leisure-Time Endurance Athletes: An Expert Consensus Statement

There are countless types of portable heart rate monitoring medical devices used variously by leisure-time exercisers, professional athletes, and chronically ill patients. Almost all the currently used heart rate monitors are capable of detecting arrhythmias, but this feature is not widely known or used among their millions of consumers. The aims of this paper were as follows: (1) to analyze the currently available sports heart rate monitors and assess their advantages and disadvantage in terms of heart rate and rhythm monitoring in endurance athletes; (2) to discuss what types of currently available commercial heart rate monitors are most convenient/adjustable to the needs of different consumers (including occasionally physically active adults and cardiac patients), bearing in mind the potential health risks, especially heart rhythm disturbances connected with endurance training; (3) to suggest a set of "optimal" design features for next-generation smart wearable devices based on the consensus opinion of an expert panel of athletes, coaches, and sports medicine doctors. Ninety-two experts aged 20 years and over, involved in endurance sports on a daily basis, were invited to participate in consensus-building discussions, including 56 long-distance runners, 18 cyclists, nine coaches, and nine physicians (sports medicine specialists, cardiologists, and family medicine doctors). The overall consensus endorsed by these experts indicates that the "optimal" sports heart rate monitor should be a one-piece device of the smartwatch type (with two or more electrodes), with integrated smartphone features, and able to collect and continually transmit data without exhibiting artifacts. It should continuously record at least a single-lead electrocardiography, send an alert after an unexpected fall, be of reasonable weight, come at an affordable price, and be user friendly

Exercise-Induced Arrhythmia or Munchausen Syndrome in a Marathon Runner?

A 36-year-old professional marathon runner reported sudden irregular palpitations occurring during competitions, with heart rates (HR) up to 230 bpm recorded on a sports HR monitor (HRM) over 4 years. These episodes subsided upon the cessation of exercise. Electrocardiograms, echocardiography, and cardiac magnetic resonance imaging results were borderline for athlete's heart. Because an electrophysiology study and standard exercise tests provoked no arrhythmia, doctors suspected Munchausen syndrome. Ultimately, an exercise test that simulated the physical effort of a competition provoked tachyarrhythmia consistent with the HRM readings. This case demonstrates the diagnostic difficulties related to exercise-induced arrhythmia and the diagnostic usefulness of sports HRMs

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

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: athlete’s heart; block S-A; bradyarrhythmia; cardioneuroablation; deconditioning; heart rate monitors; heart rate variability; leisure time activity; pacing therapy; shared decision-making

Heart rate monitors used by athletes — from gadget to medical equipment. A decade of own observations

Introduction: For many years, many athletes have reported to the Centre for Sports Cardiology in Pułtusk that during endurance training, mainly running and cycling, they found unexpected increases in heart rate (HR) values observed on sports heart rate monitors (HRMs), in the vast majority of cases without the accompanying clinical symptoms. The authors have attempted to answer the question of whether the “arrhythmia” observed on HRMs is a rhythm disturbance or a mere technical artefact. The aim of the study: This article aimed to summarize the authors’ observations in the field of the usefulness of HRMs for the assessment of cardiac arrhythmias in the situation of introducing new technological solutions in the modernized and enriched ones with new functions HRMs. Material and methods: Over ten years, numerous studies have been carried out and the world literature has been also analysed many times, finally describing the authors’ study results and observations in numerous types of English-language articles published between 2017 and 2021. In this review article, the authors focused only on their publications from the Centre for Sports Cardiology in Pułtusk on the issues of heart rhythm disturbances observed on HRMs by endurance athletes, and on publications in which researchers from CKS participated and the articles themselves were related with the use of HRMs. Only a few references have been cited from other sources. Conclusions: The HRMs used in the past years were not significant for the treatment of asymptomatic exercise-stimulated arrhythmias. These HRMs, however, in a symptomatic arrhythmia situation, became an effective diagnostic tool confirming its occurrence. The analysis of cases and literature shows that modern sports heart rate monitors used by athletes of endurance disciplines (especially with the possibility of ECG recording) are becoming a useful, important and more and more effective diagnostic tool in the detection and final diagnosis of cardiac arrhythmias stimulated by exercise, both symptomatic and asymptomatic athletes and can significantly contribute to the increase of safety during training. It can be assumed that future HRMs will have comparable diagnostic value in detecting cardiac arrhythmias as the Holter ECG, surpassing them with the possibility of constant data transmission, ease of use and affordable price

The effect of TCDD dioxin on the rat liver in biochemical and histological assessment

Eighteen male Wistar rats were divided into 3 groups of 6 animals each. Two groups received different intraperitoneal doses of TCDD (0.75 and 8 μg) in DMSO solution and the third group (control) received only DMSO on days 0, 7 and 14. On day 21 the animals were sacrificed, and then blood tests, pathological examination and CYP1A1 activity measurement were performed. In rats that received a high dose of dioxin (8 μg) hepatic lobules revealed parenchymal degeneration and vacuolization of hepatocytes was observed, and also an increased CYP reaction was found in central parts of lobules, around the central vein. The reaction in control and low dose groups was weak. The resorufin level was significantly (P<0.05) higher in the group receiving a low dose of dioxin as compared to the control group. The study confirmed that TCDD damages the rat liver in a dose-dependent manner. Administration of high TCDD doses causing major liver damage also damaged CYP1A1 (based on higher resorufin levels in epiluminescence). TCDD activates CYP1A1, which was confirmed by increased immunohistochemical reactivity of central areas of hepatic lobules

Triple immunofluorescence labeling of atherosclerotic plaque components in apoE/LDLR ^{-/-} mice

This paper presents a simple and reliable method of triple immunofluorescence staining that allows simultaneous detection of various cell types present in atherosclerotic plaque of apolipoprotein E and LDL receptor-double knockout (apoE/LDLR -/-) mice. We used combined direct and indirect procedures applying commercially available primary antibodies raised in different species to detect smooth muscle cells (Cy3-conjugated mouse anti-smooth muscle actin, SMA), macrophages (rat anti-CD68) and T lymphocytes (rabbit anti-CD3). Fixation of the material in acetone and modified incubation protocol employing nonfat dry milk in preincubation and incubation media significantly increased the intensity of labeling and effectively quenched the background. Our method offers an efficient way to detect qualitative as well as quantitative changes of macrophages, T lymphocytes and smooth muscle cells in atherosclerotic plaque of apoE/LDLR -/- mice during atherosclerosis development or in response to pharmacological treatment

Triple immunofluorescence labeling of atherosclerotic plaque components in apoE/LDLR -/- mice.

This paper presents a simple and reliable method of triple immunofluorescence staining that allows simultaneous detection of various cell types present in atherosclerotic plaque of apolipoprotein E and LDL receptor-double knockout (apoE/LDLR -/-) mice. We used combined direct and indirect procedures applying commercially available primary antibodies raised in different species to detect smooth muscle cells (Cy3-conjugated mouse anti-smooth muscle actin, SMA), macrophages (rat anti-CD68) and T lymphocytes (rabbit anti-CD3). Fixation of the material in acetone and modified incubation protocol employing nonfat dry milk in preincubation and incubation media significantly increased the intensity of labeling and effectively quenched the background. Our method offers an efficient way to detect qualitative as well as quantitative changes of macrophages, T lymphocytes and smooth muscle cells in atherosclerotic plaque of apoE/LDLR -/- mice during atherosclerosis development or in response to pharmacological treatment

What's happening? : uma plataforma de eventos

Os eventos são uma presença constante no nosso dia a dia e são divulgados através dos meios de comunicação, anúncios publicitários ou através de conversas entre amigos. A era digital trouxe consigo uma data de mudanças significativas no mundo das comunicações e consequentemente, a divulgação de eventos é facilitada devido às redes sociais que desempenham um papel importante na proliferação destes. No entanto, a procura de eventos, quer no tempo ou no espaço, não é uma tarefa fácil nos dias que correm. Apesar da evolução tecnológica ter permitido a criação de novas plataformas para divulgação de eventos, ainda existe dificuldade em saber o que está a acontecer em redor da nossa localização. Atualmente, um grande número de eventos sociais é criado e promovido nas redes sociais. Com o aglomerado de informação que estas redes geram, a experiência de procurar eventos não é a mais consistente para o utilizador porque os resultados obtidos nem sempre refletem os interesses do utilizador. Este trabalho propõe um novo conceito para uma plataforma de divulgação de eventos, intitulada de What’s Happening? com o objetivo de melhorar a experiência do utilizador na procura e recomendação destes. Em particular, é proposta uma arquitetura para a plataforma que utiliza técnicas de machine learning para classificar eventos provenientes de redes sociais populares, e.g. Facebook, com o objetivo de os categorizar. Tendo em conta que os serviços utilizados para a obtenção de eventos apresentam modelos de dados diferentes, é proposta a ontologia LODSE (Linking Open Descriptions of Social Events), tendo como base a ontologia LODE (Linking Open Descriptions of Events), com o objetivo de facilitar a integração dos dados obtidos dos serviços externos, modelar um evento social para ser posteriormente classificado e melhorar a classificação de eventos. Como forma de validação das técnicas de machine learning na arquitetura proposta bem como o modelo de dados criado a partir da ontologia LODSE, foram realizadas duas avaliações experimentais. A primeira avaliação experimental demonstrou que o melhor algoritmo para classificar os datasets de eventos criados é o Random Forest obtendo 83,33% de eventos corretamente classificados. A segunda avaliação experimental demonstrou que o modelo de dados baseado na ontologia LODSE traz benefícios na classificação de eventos demonstrando uma melhoria de 12,4% de eventos corretamente classificados bem como uma melhoria de 5,9% no tempo de processamento quando comparado com o modelo de dados baseado na ontologia LOD