{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T21:32:46Z","timestamp":1793223166944,"version":"4.5.0"},"reference-count":95,"publisher":"Elsevier BV","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jacc.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["JACC: Clinical Electrophysiology"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.jacep.2026.06.028","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T19:47:24Z","timestamp":1786132044000},"page":"2571-2589","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Emergence of Sports Electrophysiology"],"prefix":"10.1016","volume":"12","author":[{"given":"Eugene H.","family":"Chung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Darden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Zorzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Hammond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamanna","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0499-5362","authenticated-orcid":false,"given":"Jason","family":"Tso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Ackerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2042-1489","authenticated-orcid":false,"given":"Aaron L.","family":"Baggish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Jared","family":"Bunch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Haigney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew W.","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack C.","family":"Salerno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maully","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5277-9296","authenticated-orcid":false,"given":"Mark S.","family":"Link","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Lampert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H.","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"10","key":"10.1016\/j.jacep.2026.06.028_bib1","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1016\/j.jacc.2024.12.025","article-title":"Clinical considerations for competitive sports participation for athletes with cardiovascular abnormalities: a scientific statement from the American Heart Association and American College of Cardiology","volume":"85","author":"Kim","year":"2025","journal-title":"J Am Coll Cardiol"},{"issue":"10","key":"10.1016\/j.jacep.2026.06.028_bib2","doi-asserted-by":"crossref","first-page":"e151","DOI":"10.1016\/j.hrthm.2024.05.018","article-title":"2024 HRS expert consensus statement on arrhythmias in the athlete: evaluation, treatment, and return to play","volume":"21","author":"Lampert","year":"2024","journal-title":"Heart Rhythm"},{"issue":"14","key":"10.1016\/j.jacep.2026.06.028_bib3","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/j.jacc.2021.08.003","article-title":"Exercise-induced cardiovascular adaptations and approach to exercise and cardiovascular disease: JACC state-of-the-art review","volume":"78","author":"Martinez","year":"2021","journal-title":"J Am Coll Cardiol"},{"issue":"2","key":"10.1016\/j.jacep.2026.06.028_bib4","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1161\/CIRCRESAHA.125.325638","article-title":"Athlete's heart revisited: historical, clinical, and molecular perspectives","volume":"137","author":"Hsieh","year":"2025","journal-title":"Circ Res"},{"issue":"2","key":"10.1016\/j.jacep.2026.06.028_bib5","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1038\/nrcardio.2016.173","article-title":"Diagnosis, pathophysiology, and management of exercise-induced arrhythmias","volume":"14","author":"Guasch","year":"2017","journal-title":"Nat Rev Cardiol"},{"issue":"13","key":"10.1016\/j.jacep.2026.06.028_bib6","doi-asserted-by":"crossref","first-page":"e705","DOI":"10.1161\/CIR.0000000000000749","article-title":"Exercise-related acute cardiovascular events and potential deleterious adaptations following long-term exercise training: placing the risks into perspective-an update: a scientific statement from the American Heart Association","volume":"141","author":"Franklin","year":"2020","journal-title":"Circulation"},{"issue":"8","key":"10.1016\/j.jacep.2026.06.028_bib7","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1093\/eurheartj\/ehr397","article-title":"Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes","volume":"33","author":"La Gerche","year":"2012","journal-title":"Eur Heart J"},{"issue":"6","key":"10.1016\/j.jacep.2026.06.028_bib8","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1152\/japplphysiol.01280.2010","article-title":"Diverse patterns of myocardial fibrosis in lifelong, veteran endurance athletes","volume":"110","author":"Wilson","year":"2011","journal-title":"J Appl Physiol (1985)"},{"key":"10.1016\/j.jacep.2026.06.028_bib9","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1038\/s41569-020-0354-3","article-title":"The effects of endurance exercise on the heart: panacea or poison?","volume":"17","author":"Parry-Williams","year":"2020","journal-title":"Nat Rev Cardiol"},{"issue":"3","key":"10.1016\/j.jacep.2026.06.028_bib10","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/S0735-1097(02)01977-0","article-title":"Long-term clinical significance of frequent and complex ventricular tachyarrhythmias in trained athletes","volume":"40","author":"Biffi","year":"2002","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"10.1016\/j.jacep.2026.06.028_bib11","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.hrthm.2014.09.009","article-title":"Clinical significance of exercise-induced ventricular tachyarrhythmias in trained athletes without cardiovascular abnormalities","volume":"12","author":"Verdile","year":"2015","journal-title":"Heart Rhythm"},{"issue":"14","key":"10.1016\/j.jacep.2026.06.028_bib12","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1177\/2047487320925635","volume":"28","author":"Heidbuchel","year":"2021","journal-title":"Eur J Prev Cardiol"},{"issue":"1","key":"10.1016\/j.jacep.2026.06.028_bib13","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jacc.2023.08.017","article-title":"2023 ACC\/AHA\/ACCP\/HRS Guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"83","author":"Joglar","year":"2024","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"10.1016\/j.jacep.2026.06.028_bib14","first-page":"567","article-title":"Atrial fibrillation in endurance athletes: from mechanism to management","volume":"34","author":"Elliott","year":"2016","journal-title":"Cardiol Clin"},{"issue":"11","key":"10.1016\/j.jacep.2026.06.028_bib15","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1007\/s11936-017-0583-x","article-title":"Management of arrhythmias in athletes: atrial fibrillation, premature ventricular contractions, and ventricular tachycardia","volume":"19","author":"Lai","year":"2017","journal-title":"Curr Treat Options Cardiovasc Med"},{"key":"10.1016\/j.jacep.2026.06.028_bib16","doi-asserted-by":"crossref","first-page":"S46","DOI":"10.1016\/j.hrthm.2024.03.346","article-title":"A novel approach to arrhythmia management in athletes: 5-year experience from a multidisciplinary clinic","volume":"21","author":"Stewart","year":"2024","journal-title":"Heart Rhythm"},{"issue":"2","key":"10.1016\/j.jacep.2026.06.028_bib17","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.124.013261","article-title":"Impact of diagnosis to ablation time on recurrence of atrial fibrillation and clinical outcomes after catheter ablation: a systematic review and meta-analysis with reconstructed time-to-event data","volume":"18","author":"Amin","year":"2025","journal-title":"Circ Arrhythm Electrophysiol"},{"issue":"10","key":"10.1016\/j.jacep.2026.06.028_bib18","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1016\/j.jacep.2020.05.009","article-title":"Outcomes of pulmonary vein isolation in athletes","volume":"6","author":"Mandsager","year":"2020","journal-title":"JACC Clin Electrophysiol"},{"issue":"8","key":"10.1016\/j.jacep.2026.06.028_bib19","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1016\/j.jacc.2017.01.015","article-title":"International recommendations for electrocardiographic interpretation in athletes","volume":"69","author":"Sharma","year":"2017","journal-title":"JACC"},{"issue":"4","key":"10.1016\/j.jacep.2026.06.028_bib20","doi-asserted-by":"crossref","first-page":"4494","DOI":"10.1016\/j.ijcard.2013.06.123","article-title":"Prevalence and clinical meaning of isolated increase of QRS voltages in hypertrophic cardiomyopathy versus athlete\u2019s heart: relevance to athletic screening","volume":"168","author":"Calore","year":"2013","journal-title":"Int J Cardiol"},{"issue":"3","key":"10.1016\/j.jacep.2026.06.028_bib21","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.115.003577","article-title":"Early repolarization in athletes","volume":"9","author":"Aagaard","year":"2016","journal-title":"Circ Arrhythm Electrophysiol"},{"issue":"12","key":"10.1016\/j.jacep.2026.06.028_bib22","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1161\/CIRCULATIONAHA.118.037615","article-title":"Left atrial electromechanical remodeling following 2 years of high-intensity exercise training in sedentary middle-aged adults","volume":"139","author":"McNamara","year":"2019","journal-title":"Circulation"},{"key":"10.1016\/j.jacep.2026.06.028_bib23","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.ahj.2020.05.015","article-title":"High-intensity endurance training is associated with left atrial fibrosis","volume":"226","author":"Peritz","year":"2020","journal-title":"Am Heart J"},{"issue":"12","key":"10.1016\/j.jacep.2026.06.028_bib24","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1093\/ehjci\/jeaa183","article-title":"Differing mechanisms of atrial fibrillation in athletes and non-athletes: alterations in atrial structure and function","volume":"21","author":"Trivedi","year":"2020","journal-title":"Eur Heart J Cardiovasc Imaging"},{"issue":"14","key":"10.1016\/j.jacep.2026.06.028_bib25","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1136\/bjsports-2011-090378","article-title":"Exercise-associated collapse: an evidence-based review and primer for clinicians","volume":"45","author":"Asplund","year":"2011","journal-title":"Br J Sports Med"},{"issue":"7","key":"10.1016\/j.jacep.2026.06.028_bib26","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1007\/s40279-018-0911-7","article-title":"Pathophysiology of noncardiac syncope in athletes","volume":"48","author":"Christou","year":"2018","journal-title":"Sports Med"},{"issue":"9","key":"10.1016\/j.jacep.2026.06.028_bib27","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1249\/JSR.0000000000000879","article-title":"A video-enhanced, electronic modality for preparticipation examination of young athletes","volume":"20","author":"Parizher","year":"2021","journal-title":"Curr Sports Med Rep"},{"issue":"13","key":"10.1016\/j.jacep.2026.06.028_bib28","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1177\/2047487318791289","article-title":"Circumstances of cardiac arrest during sports activity recorded on video","volume":"25","author":"Zorzi","year":"2018","journal-title":"Eur J Prev Cardiol"},{"issue":"1","key":"10.1016\/j.jacep.2026.06.028_bib29","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1111\/sms.12624","article-title":"Symptoms, diagnoses, and sporting consequences among athletes referred to a Danish sports cardiology clinic","volume":"27","author":"Kaiser-Nielsen","year":"2017","journal-title":"Scand J Med Sci Sports"},{"key":"10.1016\/j.jacep.2026.06.028_bib30","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2022.896148","article-title":"Holter-determined arrhythmias in young elite athletes with suspected risk: insights from a 20-year experience","volume":"9","author":"Boraita","year":"2022","journal-title":"Front Cardiovasc Med"},{"issue":"2","key":"10.1016\/j.jacep.2026.06.028_bib31","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1093\/eurjpc\/zwac224","article-title":"Reproducibility of ventricular arrhythmias at exercise testing for prediction of non-ischaemic left ventricular scar in athletes","volume":"30","author":"Brunetti","year":"2023","journal-title":"Eur J Prev Cardiol"},{"issue":"12","key":"10.1016\/j.jacep.2026.06.028_bib32","doi-asserted-by":"crossref","first-page":"2044","DOI":"10.1016\/j.amjcard.2019.03.027","article-title":"Diagnostic yield of customized exercise provocation following routine testing","volume":"123","author":"Churchill","year":"2019","journal-title":"Am J Cardiol"},{"issue":"5","key":"10.1016\/j.jacep.2026.06.028_bib33","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.echo.2020.02.009","volume":"33","author":"Baggish","year":"2020","journal-title":"J Am Soc Echocardiogr"},{"issue":"4","key":"10.1016\/j.jacep.2026.06.028_bib34","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.jcmg.2025.10.024","article-title":"cardiovascular imaging considerations for masters-aged athletes","volume":"19","author":"Phelan","year":"2026","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.jacep.2026.06.028_bib35","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1056\/NEJMra2301903","article-title":"Wearable digital health technologies for monitoring in cardiovascular medicine","volume":"390","author":"Spatz","year":"2024","journal-title":"New Engl J Med"},{"issue":"3","key":"10.1016\/j.jacep.2026.06.028_bib36","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.jacc.2023.04.054","article-title":"Consumer wearable health and fitness technology in cardiovascular medicine: JACC state-of-the-art review","volume":"82","author":"Petek","year":"2023","journal-title":"J Am Coll Cardiol"},{"issue":"20","key":"10.1016\/j.jacep.2026.06.028_bib37","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1056\/NEJMoa1901183","article-title":"Large-scale assessment of a smartwatch to identify atrial fibrillation","volume":"381","author":"Perez","year":"2019","journal-title":"N Engl J Med"},{"issue":"19","key":"10.1016\/j.jacep.2026.06.028_bib38","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1161\/CIRCULATIONAHA.122.060291","article-title":"Detection of atrial fibrillation in a large population using wearable devices: the Fitbit heart study","volume":"146","author":"Lubitz","year":"2022","journal-title":"Circulation"},{"issue":"1","key":"10.1016\/j.jacep.2026.06.028_bib39","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/HCO.0000000000000817","article-title":"Consumer wearable technologies to identify and monitor exercise-related arrhythmias in athletes","volume":"36","author":"Sanchis-Gomar","year":"2021","journal-title":"Curr Opin Cardiol"},{"issue":"5","key":"10.1016\/j.jacep.2026.06.028_bib40","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.hrthm.2024.01.021","article-title":"\"But for the blind spot\": accuracy and diagnostic performance of smart watch cardiac features in pediatric patients","volume":"21","author":"Nash","year":"2024","journal-title":"Heart Rhythm"},{"issue":"5","key":"10.1016\/j.jacep.2026.06.028_bib41","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/j.jelectrocard.2015.07.010","article-title":"Smartphone ECG aids real time diagnosis of palpitations in the competitive college athlete","volume":"48","author":"Peritz","year":"2015","journal-title":"J Electrocardiol"},{"key":"10.1016\/j.jacep.2026.06.028_bib42","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1093\/europace\/euv216","article-title":"Emerging risk factors and the dose-response relationship between physical activity and lone atrial fibrillation: a prospective case-control study","volume":"18","author":"Calvo","year":"2016","journal-title":"Europace"},{"issue":"21","key":"10.1016\/j.jacep.2026.06.028_bib43","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1136\/bjsports-2021-103994","article-title":"Risk of atrial fibrillation in athletes: a systematic review and meta-analysis","volume":"55","author":"Newman","year":"2021","journal-title":"Br J Sports Med"},{"key":"10.1016\/j.jacep.2026.06.028_bib44","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1038\/s41569-024-01053-7","article-title":"Pulsed-field ablation: a revolution in atrial fibrillation therapy","volume":"21","author":"Maizels","year":"2024","journal-title":"Nat Rev Cardiol"},{"issue":"4","key":"10.1016\/j.jacep.2026.06.028_bib45","doi-asserted-by":"crossref","first-page":"138","DOI":"10.31083\/j.rcm2504138","article-title":"Pulsed field ablation for atrial fibrillation: mechanisms, advantages, and limitations","volume":"25","author":"Jiang","year":"2024","journal-title":"Rev Cardiovasc Med"},{"issue":"19","key":"10.1016\/j.jacep.2026.06.028_bib46","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1161\/CIRCULATIONAHA.123.063988","article-title":"Pulsed field ablation for the treatment of atrial fibrillation: PULSED AF pivotal trial","volume":"147","author":"Verma","year":"2023","journal-title":"Circulation"},{"issue":"15","key":"10.1016\/j.jacep.2026.06.028_bib47","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1056\/NEJMoa2502280","article-title":"Pulsed field or cryoballoon ablation for paroxysmal atrial fibrillation","volume":"392","author":"Reichlin","year":"2025","journal-title":"N Engl J Med"},{"issue":"11","key":"10.1016\/j.jacep.2026.06.028_bib48","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1093\/europace\/euab155","article-title":"Pulsed field ablation prevents chronic atrial fibrotic changes and restrictive mechanics after catheter ablation for atrial fibrillation","volume":"23","author":"Nakatani","year":"2021","journal-title":"Europace"},{"issue":"1","key":"10.1016\/j.jacep.2026.06.028_bib49","first-page":"68","article-title":"LA PULSE: evaluating left atrial function pre- and post-atrial fibrillation ablation using PULSEd field ablation","volume":"14","author":"Mahrous","year":"2024","journal-title":"Clin Med"},{"key":"10.1016\/j.jacep.2026.06.028_bib50","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1007\/s10840-025-02080-1","article-title":"Pulsed-field ablation beyond pulmonary vein for persistent atrial fibrillation: efficacy and impact on left atrial function","volume":"68","author":"Zaher","year":"2025","journal-title":"J Interv Card Electrophysiol"},{"issue":"7 Pt 2","key":"10.1016\/j.jacep.2026.06.028_bib51","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1016\/j.jacep.2024.05.005","article-title":"Autonomic effects of pulsed field vs thermal ablation for treating atrial fibrillation: subanalysis of ADVENT","volume":"10","author":"Gerstenfeld","year":"2024","journal-title":"JACC Clin Electrophysiol"},{"key":"10.1016\/j.jacep.2026.06.028_bib52","doi-asserted-by":"crossref","DOI":"10.1016\/j.hrthm.2026.02.006","article-title":"2026 HRS\/EHRA scientific statement on pulsed field ablation for cardiac arrhythmias","author":"Verma","year":"2026","journal-title":"Heart Rhythm"},{"issue":"9","key":"10.1016\/j.jacep.2026.06.028_bib53","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1161\/CIRCULATIONAHA.125.076170","article-title":"Bradycardia in athletes: prevalence, mechanisms, and risks","volume":"153","author":"D\u2019Ambrosio","year":"2025","journal-title":"Circulation"},{"key":"10.1016\/j.jacep.2026.06.028_bib54","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1093\/eurheartj\/ehm555","article-title":"Sinus node disease and arrhythmias in the long-term follow-up of former professional cyclists","volume":"29","author":"Baldesberger","year":"2008","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacep.2026.06.028_bib55","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1161\/CIRCULATIONAHA.123.068280","article-title":"Long-term incidence of bradycardia and pacemaker implantations among cross-country skiers: a cohort study","volume":"150","author":"Svedberg","year":"2024","journal-title":"Circulation"},{"issue":"21","key":"10.1016\/j.jacep.2026.06.028_bib56","doi-asserted-by":"crossref","first-page":"2541","DOI":"10.1093\/eurheartj\/ehag040","article-title":"Masters athletes with abnormal cardiovascular findings: a clinical consensus statement of the European Association of Preventative Cardiology of the ESC and the American College of Cardiology","volume":"47","author":"Eijsvogels","year":"2026","journal-title":"Eur Heart J"},{"issue":"11","key":"10.1016\/j.jacep.2026.06.028_bib57","doi-asserted-by":"crossref","DOI":"10.31083\/RCM42738","article-title":"Intrinsic versus extrinsic sinus and atrioventricular nodes dysfunction in athletes: insights from transesophageal electrophysiological testing with autonomic blockade","volume":"26","author":"Bondarev","year":"2025","journal-title":"Rev Cardiovasc Med"},{"key":"10.1016\/j.jacep.2026.06.028_bib58","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.1016\/j.hrthm.2023.03.1538","article-title":"2023 HRS\/APHRS\/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure","volume":"20","author":"Chung","year":"2023","journal-title":"Heart Rhythm"},{"issue":"7","key":"10.1016\/j.jacep.2026.06.028_bib59","doi-asserted-by":"crossref","first-page":"e51","DOI":"10.1016\/j.jacc.2018.10.044","volume":"74","author":"Kusumoto","year":"2019","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"10.1016\/j.jacep.2026.06.028_bib60","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.jacep.2017.10.009","article-title":"Life-threatening event risk in children with Wolff-Parkinson-White syndrome: a multicenter international study","volume":"4","author":"Etheridge","year":"2018","journal-title":"JACC Clin Electrophysiol"},{"issue":"9","key":"10.1016\/j.jacep.2026.06.028_bib61","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euad255","article-title":"Ventricular arrhythmias recorded on 12-lead ambulatory electrocardiogram monitoring in healthy volunteer athletes and controls: what is common and what is not","volume":"25","author":"Graziano","year":"2023","journal-title":"Europace"},{"issue":"8","key":"10.1016\/j.jacep.2026.06.028_bib62","doi-asserted-by":"crossref","first-page":"846","DOI":"10.23736\/S0022-4707.24.16084-7","article-title":"Incidence and characteristics of premature ventricular beats at exercise testing for preparticipation screening","volume":"64","author":"Pizzolato","year":"2024","journal-title":"J Sports Med Phys Fitness"},{"key":"10.1016\/j.jacep.2026.06.028_bib63","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijcard.2023.131220","article-title":"Interpretation and management of premature ventricular beats in athletes: an expert opinion document of the Italian Society of Sports Cardiology (SICSPORT)","volume":"391","author":"Zorzi","year":"2023","journal-title":"Int J Cardiol"},{"issue":"9","key":"10.1016\/j.jacep.2026.06.028_bib64","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.124.040072","article-title":"Cardiac channelopathies: clinical diagnosis and promising therapeutics","volume":"14","author":"Dib Nehme","year":"2025","journal-title":"J Am Heart Assoc"},{"issue":"3","key":"10.1016\/j.jacep.2026.06.028_bib65","doi-asserted-by":"crossref","DOI":"10.1111\/anec.12723","article-title":"Arrhythmic events in Brugada syndrome patients induced by fever","volume":"25","author":"Roterberg","year":"2020","journal-title":"Ann Noninvasive Electrocardiol"},{"issue":"2","key":"10.1016\/j.jacep.2026.06.028_bib66","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/anec.12288","article-title":"Fever-induced Brugada syndrome is more common than previously suspected: a cross-sectional study from an endemic area","volume":"21","author":"Rattanawong","year":"2016","journal-title":"Ann Noninvasive Electrocardiol"},{"key":"10.1016\/j.jacep.2026.06.028_bib67","author":"Chung"},{"issue":"2","key":"10.1016\/j.jacep.2026.06.028_bib68","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.121.010221","article-title":"Integrating exercise into personalized ventricular arrhythmia risk prediction in arrhythmogenic right ventricular cardiomyopathy","volume":"15","author":"Bosman","year":"2022","journal-title":"Circ Arrhythm Electrophysiol"},{"issue":"4","key":"10.1016\/j.jacep.2026.06.028_bib69","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/j.hlc.2019.12.007","article-title":"Exercise and arrhythmogenic right ventricular cardiomyopathy","volume":"29","author":"Prior","year":"2020","journal-title":"Heart Lung Circ"},{"issue":"1","key":"10.1016\/j.jacep.2026.06.028_bib70","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.018206","article-title":"Predictors of left ventricular scar using cardiac magnetic resonance in athletes with apparently idiopathic ventricular arrhythmias","volume":"10","author":"Crescenzi","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.jacep.2026.06.028_bib71","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1056\/NEJM199508103330602","article-title":"Blunt impact to the chest leading to sudden death from cardiac arrest during sports activities","volume":"333","author":"Maron","year":"1995","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacep.2026.06.028_bib72","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1056\/NEJM199806183382504","article-title":"An experimental model of sudden death due to low-energy chest-wall impact (commotio cordis)","volume":"338","author":"Link","year":"1998","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacep.2026.06.028_bib73","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.jacc.2016.10.061","article-title":"Cardiac pacemakers: function, troubleshooting, and management","volume":"69","author":"Mulpuru","year":"2017","journal-title":"JACC"},{"issue":"31","key":"10.1016\/j.jacep.2026.06.028_bib74","article-title":"Cardiopulmonary exercise testing-guided optimization of pacemaker rate-response in an endurance athlete with sinus node dysfunction","volume":"30","author":"Hsieh","year":"2025","journal-title":"JACC Case Rep"},{"issue":"15","key":"10.1016\/j.jacep.2026.06.028_bib75","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.122.029126","article-title":"Single- versus dual-chamber implantable cardioverter-defibrillator for primary prevention of sudden cardiac death in the United States","volume":"12","author":"Margolis","year":"2023","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.jacep.2026.06.028_bib76","doi-asserted-by":"crossref","first-page":"1782","DOI":"10.1016\/j.hrthm.2024.09.039","article-title":"Long-term performance of subcutaneous implantable defibrillators in athletes: a multicenter, real-world analysis of sport activities from the iSUSI registry","volume":"22","author":"Gasperetti","year":"2025","journal-title":"Heart Rhythm"},{"key":"10.1016\/j.jacep.2026.06.028_bib77","doi-asserted-by":"crossref","first-page":"1896","DOI":"10.1016\/j.jacep.2024.02.033","article-title":"Extravascular implantable cardioverter-defibrillator sensing and detection in a large global population","volume":"10","author":"Swerdlow","year":"2024","journal-title":"JACC Clin Electrophysiol"},{"key":"10.1016\/j.jacep.2026.06.028_bib78","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1016\/j.hrcr.2025.10.028","article-title":"Exercise-guided programming of a subcutaneous implantable cardioverter-defibrillator in an athlete","volume":"11","author":"Hsieh","year":"2025","journal-title":"HeartRhythm Case Rep"},{"key":"10.1016\/j.jacep.2026.06.028_bib79","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.hrthm.2018.10.032","article-title":"Competitive athletes with implantable cardioverter-defibrillators-how to program? Data from the implantable cardioverter-defibrillator sports registry","volume":"16","author":"Olshansky","year":"2019","journal-title":"Heart Rhythm"},{"issue":"13","key":"10.1016\/j.jacep.2026.06.028_bib80","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1016\/j.jacc.2025.02.010","article-title":"The cardiovascular care of the pediatric athlete","volume":"85","author":"Dean","year":"2025","journal-title":"J Am Coll Cardiol"},{"issue":"20","key":"10.1016\/j.jacep.2026.06.028_bib81","doi-asserted-by":"crossref","first-page":"1988","DOI":"10.1093\/eurheartj\/ehab148","article-title":"Clinical characteristics and outcomes in childhood-onset hypertrophic cardiomyopathy","volume":"42","author":"Marston","year":"2021","journal-title":"Eur Heart J"},{"issue":"22","key":"10.1016\/j.jacep.2026.06.028_bib82","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1161\/01.CIR.97.22.2237","article-title":"Age- and sex-related differences in clinical manifestations in patients with congenital long-QT syndrome: findings from the International LQTS registry","volume":"97","author":"Locati","year":"1998","journal-title":"Circulation"},{"issue":"10","key":"10.1016\/j.jacep.2026.06.028_bib83","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1093\/europace\/euy067","article-title":"Sex differences in cardiac arrhythmia: a consensus document of the European Heart Rhythm Association, endorsed by the Heart Rhythm Society and Asia Pacific Heart Rhythm Society","volume":"20","author":"Linde","year":"2018","journal-title":"Europace"},{"issue":"10","key":"10.1016\/j.jacep.2026.06.028_bib84","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1016\/j.jacc.2023.05.070","article-title":"Impact of sex on cardiovascular adaptations to exercise: JACC review topic of the week","volume":"82","author":"Petek","year":"2023","journal-title":"J Am Coll Cardiol"},{"issue":"9","key":"10.1016\/j.jacep.2026.06.028_bib85","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1046\/j.1540-8167.2001.00986.x","article-title":"Effect of gender on atrial electrophysiologic changes induced by rapid atrial pacing and elevation of atrial pressure","volume":"12","author":"Tse","year":"2001","journal-title":"J Cardiovasc Electrophysiol"},{"issue":"12","key":"10.1016\/j.jacep.2026.06.028_bib86","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1093\/eurheartj\/ehab833","article-title":"Risk of sports-related sudden cardiac death in women","volume":"43","author":"Rajan","year":"2022","journal-title":"Eur Heart J"},{"issue":"18","key":"10.1016\/j.jacep.2026.06.028_bib87","doi-asserted-by":"crossref","first-page":"2108","DOI":"10.1016\/j.jacc.2016.02.062","article-title":"Etiology of sudden death in sports: insights from a United Kingdom regional registry","volume":"67","author":"Finocchiaro","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jacep.2026.06.028_bib88","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s11936-025-01076-4","article-title":"Exercise at the extremes: toward understanding of increased cardiovascular risk in the tactical athlete","volume":"27","author":"Murphy","year":"2025","journal-title":"Curr Treat Options Cardio Med"},{"issue":"6","key":"10.1016\/j.jacep.2026.06.028_bib89","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/j.amjmed.2025.02.003","article-title":"No one left behind: incidence of sudden cardiac arrest and 30-day survival in military members","volume":"138","author":"Franzos","year":"2025","journal-title":"Am J Med"},{"key":"10.1016\/j.jacep.2026.06.028_bib90","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1161\/CIRCULATIONAHA.123.065908","article-title":"Sudden cardiac death in National Collegiate Athletic Association athletes: a 20-year study","volume":"149","author":"Petek","year":"2024","journal-title":"Circulation"},{"issue":"1","key":"10.1016\/j.jacep.2026.06.028_bib91","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/2046-7648-2-6","article-title":"Extreme sacrifice: sudden cardiac death in the US Fire Service","volume":"2","author":"Smith","year":"2013","journal-title":"Extreme Physiol Med"},{"issue":"8","key":"10.1016\/j.jacep.2026.06.028_bib92","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1016\/j.jacep.2021.04.008","article-title":"Use of single-patch electrode ambulatory monitoring devices in variable thoracic locations in small children","volume":"7","author":"Samson","year":"2021","journal-title":"JACC Clin Electrophysiol"},{"issue":"6 Pt 1","key":"10.1016\/j.jacep.2026.06.028_bib93","doi-asserted-by":"crossref","first-page":"102791","DOI":"10.1016\/j.jacadv.2026.102791","article-title":"Gestational changes in exercise capacity in uncomplicated singleton pregnancies","volume":"5","author":"Dwyer","year":"2026","journal-title":"JACC Adv"},{"issue":"6","key":"10.1016\/j.jacep.2026.06.028_bib94","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/j.jacep.2022.02.013","article-title":"Comparison of 2 smart watch algorithms for detection of atrial fibrillation and the benefit of clinician interpretation: SMART WARS study","volume":"8","author":"Ford","year":"2022","journal-title":"JACC Clin Electrophysiol"},{"issue":"5","key":"10.1016\/j.jacep.2026.06.028_bib95","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.jacc.2023.05.034","article-title":"Postapproval study of a subcutaneous implantable cardioverter-defibrillator system","volume":"82","author":"Gold","year":"2023","journal-title":"J Am Coll Cardiol"}],"container-title":["JACC: Clinical Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2405500X26005815?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2405500X26005815?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T20:40:16Z","timestamp":1793220016000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2405500X26005815"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":95,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["S2405500X26005815"],"URL":"https:\/\/doi.org\/10.1016\/j.jacep.2026.06.028","relation":{},"ISSN":["2405-500X"],"issn-type":[{"value":"2405-500X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The Emergence of Sports Electrophysiology","name":"articletitle","label":"Article Title"},{"value":"JACC: Clinical Electrophysiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jacep.2026.06.028","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 by the American College of Cardiology Foundation. Published by Elsevier.","name":"copyright","label":"Copyright"}]}}