Objectives: While regular physical exercise has many health benefits,
strenuous physical exercise may have a negative impact on cardiac function.
The ‘Berlin Beat of Running’ study focused on feasibility and diagnostic value
of continuous ECG monitoring in recreational endurance athletes during a
marathon race. We hypothesised that cardiac arrhythmias and especially atrial
fibrillation are frequently found in a cohort of recreational endurance
athletes. The main secondary hypothesis was that pathological laboratory
findings in these athletes are (in part) associated with cardiac arrhythmias.
Design: Prospective observational cohort study including healthy volunteers.
Setting and participants: One hundred and nine experienced marathon runners
wore a portable ECG recorder during a marathon race in Berlin, Germany.
Athletes underwent blood tests 2–3 days prior, directly after and 1–2 days
after the race. Results: Overall, 108 athletes (median 48 years (IQR 45–53),
24% women) completed the marathon in 249±43 min. Blinded ECG analysis revealed
abnormal findings during the marathon in 18 (16.8%) athletes. Ten (9.3%)
athletes had at least one episode of non-sustained ventricular tachycardia,
one of whom had atrial fibrillation; eight (7.5%) individuals showed transient
ST-T-segment deviations. Abnormal ECG findings were associated with advanced
age (OR 1.11 per year, 95% CI 1.01 to 1.23), while sex and cardiovascular risk
profile had no impact. Directly after the race, high-sensitive troponin T was
elevated in 18 (16.7%) athletes and associated with ST-T-segment deviation (OR
9.9, 95% CI 1.9 to 51.5), while age, sex and cardiovascular risk profile had
no impact. Conclusions: ECG monitoring during a marathon is feasible. Abnormal
ECG findings were present in every sixth athlete. Exercise-induced transient
ST-T-segment deviations were associated with elevated high-sensitive troponin
T (hsTnT) values. Trial registration: ClinicalTrials.gov NCT01428778; Results
