Evaluacija jednokanalnog telemetrijskog EKG uređaja u različitim submaksimalnim i maksimalnim laboratorijskim i terenskim testovima

Abstract

Iznenadna srčana smrt je jedan od najčešćih uzroka smrti među sportistima jer uzrokuje čak 90% smrti. Najčešći razlozi za iznenadnu srčanu smrt kod mladih sportista su neotkrivene aritmije, hipertrofične kardiomiopatije i anomalije koronarnih arterija sa predominacijom glavne, leve koronarne arterije. Dve francuske studije pokazale su da dnevno dolazi do 3 iznenadne srčane smrti i do 4 infarkta miokarda kod rekreativnih sportista. Prema dostupnim podacima u više od 80% slučajeva iznenadne srčane smrti kod mladih sportista smrt je nastupila u prvih 30 minuta bavljenja aktivnošću, što ukazuje na činjenicu da je povećana fizička aktivnost bila okidač srčanih aritmija koje su za sportistu sa neotkrivenim srčanim oboljenjima bile fatalne. Pošto je sportsko srce veoma kompleksan, nedovoljno istražen fenomen, koji predstavlja sivu zonu između fiziologije i patologije, potrebno je jasno razgraničiti patološke karakteristike kardiovaskularnog sistema od adaptacije na fizički napor. Istraživanja su pokazala da 55-80% sportista umrlih od iznenadne srčane smrti nije imalo nikakve prethodne simptome oboljenja srca. Alat za otkrivanje ovakvih slučajeva mogle bi predstavljati nove tehnologije koje se uvode u sportsku praksu, zato se ova disertacija bavi evaluacijom signala telemetrijskog EKG uređaja u submaksimalnim i maksimalnim laboratorijskim i terenskim testovima. Cilj ove disertacije je da istraži (1) da li je sa telemetrijskim EKG uređajem moguće kvalitetno meriti EKG signal u toku fizičke aktivnosti u laboratorijskim i terenskim testovima, (2) da li je EKG signal izmeren na poziciji LI kvalitetniji nego na poziciji LS, (3) da li složenost i uslovi testiranja utiču na kvalitet signala i (4) da li odabir pravog načina fiksacije smanjuje broj remetećih faktora. U ovom istraživanju su učestvovala dvadesetitri ispitanika, koji su po dva puta odradili pet različitih laboratorijskih i terenskih testova maksimalnog i submaksimalnog intenziteta. U laboratoriji su uradili testove opterećenja na bicikl ergometru i na tredmilu po RAMP protokolu, a terenski testovi koje su uradili su: Šatl ran, sprint na 100 m i Kuperov test 2400 m. U svim testovima na sebi su imali pričvršćen telemetrijski EKG uređaj, a način pričvršćivanja u prvom i u ponovljenom testiranju bio je različit...

Sudden cardiac arrest is one of the most common causes of death among athletes, even up to 90% of such deaths. The most common reasons are undetected arrhythmias, hypertrophic cardiomyopathy, and coronary artery abnormalities with predominant left coronary artery abnormalities. Two studies conducted in France reported a daily incidence of three sudden deaths and four myocardial infarctions among the recreational population. Due to the literature more than 80% of sudden cardiac death happened in the first 30 minutes after physical activity ended. This indicates that the physical activity was what triggered the cardiac arrhythmias that proved fatal for the athletes. Athletic cardiology is a gray zone between physiology and pathology, wherefore it is necessary to distinguish the pathological characteristics of the cardiovascular system and ensure proper adaptation to a given physical activity. Taking into account the fact that as many as 55-80% of athletes who died on the court had no previous cardiac problems or symptoms, the question is what else could be done to detect people with increased risks. New technologies can serve as a tool to detect such problems, which is why this dissertation evaluates a telemetric ECG device in submaximal and maximal laboratory and field tests. The aims of this dissertation are to find out (1) whether it is possible to measure an ECG signal with a telemetric ECG device during physical activity in both laboratory and field tests, (2) whether the ECG signal measured on the LI position is of better quality than that on the LS position, (3) whether the complexity of the task influences the quality of the signal, and (4) whether proper affixation reduces the number of disturbing factors. There were 23 participants included in this study. Every participant was subjected to five different laboratory and field tests of maximal and submaximal intensity. In the laboratory they completed exercise stress tests on a treadmill and cycle ergometer, while the field tests were a shuttle run, a Cooper 2400 m, and a 100-m sprint. In all the tests they had the device attached to the body, while in the second test the gadget was additionally fixed. The results show that in all running tests the difference in a quality of ECG signal between the first and second test were at a significance level between p=0.000, and p=0.015, while the difference for the cycle ergometer difference was not significant...