BACKGROUND: High-level endurance training has been associated with right ventricular pathological remodeling and @entity1165 ( @entity1165 ). Although overlap with @entity4128 ( @entity4128 ) has been  suggested, the arrhythmogenic substrate for VTs in athletes is unknown. OBJECTIVES: The goal of this study was to evaluate whether electroanatomic scar patterns related to sustained @entity1165 can distinguish exercise-induced arrhythmogenic remodeling from @entity4128 and post-inflammatory @entity296 . METHODS: In 57 consecutive @entity1 (mean age 48    16 years; 83% male) undergoing catheter ablation for scar-related right ventricular @entity1165 , 2 distinct scar distributions were identified: 1) scars involving the subtricuspid right ventricle in 46 @entity1 (group A); and 2) scars restricted to the anterior subepicardial right ventricular outflow tract  in 11 @entity1 (group B). RESULTS: Definite @entity4128 or post-inflammatory @entity296 was diagnosed in 40 (87%) of 46 group A @entity1 but was not diagnosed in any @entity1 in group B. All group B @entity1 underwent intensive endurance training for a median of 15 h/week (interquartile range [IQR]: 10 to 20 h/week) for a median of 13 years (IQR: 10 to 18 years). The cycle lengths of scar-related VTs were significantly faster in group B @entity1 (257    34 ms vs. 328    72 ms in group A; p  =  0.003). Catheter ablation resulted in complete procedural success in 10 (91%) of 11 group B @entity1 compared with  26 (57%) of 46 group A @entity1 (p  = 0.034). During a median follow-up of 27 months (IQR: 6 to 62 months), 50% of group A @entity1 but none of the group B @entity1 had a @entity1165 recurrence. CONCLUSIONS: This study describes a novel clinical entity of an isolated subepicardial right ventricular outflow tract scar serving as a substrate for fast @entity1165 in high-level endurance athletes that can be successfully treated by ablation. This scar  pattern may allow distinguishing exercise-induced arrhythmogenic remodeling from @entity4128 and post-inflammatory @entity296 .

Isolated Subepicardial Right Ventricular Outflow Tract Scar in Athletes With XXXX .

@entity4128 :: ('MESH:D019571', 'Disease') :: ['arrhythmogenic right ventricular cardiomyopathy', 'ARVC'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity296 :: ('MESH:D009202', 'Disease') :: ['cardiomyopathies', 'cardiomyopathy'] @entity1165 :: ('MESH:D017180', 'Disease') :: ['VT', 'ventricular tachycardia']
@entity1165 :: (MESH:D017180,Disease) :: ['Ventricular  Tachycardia']
