Premature Ventricular Contractions in Athletes
Premature ventricular contractions (PVCs) occur in a sizable minority of athletes with a prevalence similar to sedentary counterparts. Although the majority of PVCs are benign, further evaluation is often warranted to evaluate for underlying arrhythmogenic substrate which may increase sudden cardiac death (SCD) risk even in the asymptomatic athlete. In those with PVCs, appropriate risk assessment, management, and sport recommendations requires a systematic approach. PVC burden and morphology along with imaging and exercise testing can provide insight into the diagnosis and risk-stratification, while management and sports eligibility largely depend on symptoms and the underlying etiology.

#PVCs frequently occur in athletes, although similar in amount to sedentary counterparts. The morphology and complexity of PVCs are more predictive of underlying disease than overall burden.
#Prognosis and management are dependent on whether there is an underlying cardiac disorder. Comprehensive evaluation is often required in those deemed high-risk including thorough history and physical exam, ECG, 24-hour Holter monitor, echocardiogram, exercise testing, cardiac magnetic resonance imaging, and occasionally invasive testing such as electrophysiology study or endomyocardial biopsy.
#The majority of PVCs in athletes are benign and may spontaneously resolve, although recognition and evaluation of PVCs associated with cardiomyopathies or channelopathies may prevent sudden cardiac death.

Evaluation and management of PVCs in athletes is complex and requires detailed history taking and comprehensive evaluation to rule out an underlying myocardial disease. Accurate risk-stratification, diagnosis, and shared decision making are key for optimal management.