Scar tissue in athletes hearts tied to higher risk of dangerous cardiac rhythms
Scar tissue in the heart may be linked to dangerous heart rhythms in otherwise healthy athletes, according to a U.K. study.
The study, VENTOUX, named after Mont Ventouxone of the most gruelling climbs in the world-renowned Tour de France cycling raceincluded about 100 male cyclists and triathletes over age 50.
Embargoed until 6:01 p.m. CT/7:01 p.m. ET, Thursday, July 17, 2025
(NewMediaWire) - July 17, 2025 - DALLAS Scar tissue in the heart was associated with abnormal heart rhythms among healthy, long-time male endurance athletes age 50 or older, potentially increasing their risk of sudden cardiac death, according to a small study published today in Circulation:Cardiovascular Imaging, an American Heart Association journal.
An irregular rhythm originating from a ventricular heart chamber, called ventricular tachycardia, is considered one of the most serious types of abnormal heart rhythm. It is extremely dangerous and can lead to sudden cardiac death. Sudden cardiac arrest is a leading cause of death in athletes, mostly affecting older men.
Myocardial fibrosisthe scarring or thickening of heart muscle tissuehas previously been linked to irregular heartbeats; however, how it affects otherwise healthy endurance athletes remains unclear.
"Dangerous heart rhythms during sport are thankfully rare," said senior study author Peter Swoboda, M.B.B.S., Ph.D., an associate professor of cardiology at the University of Leeds in the U.K. "In certain highly trained athletesparticularly as they get olderit is possible to identify scarred heart tissue via magnetic resonance imaging. We wanted to investigate whether dangerous heart rhythms in endurance athletes might be caused by heart scarring.
"Our main aim was to help endurance athletes continue to participate safely in sports, particularly as they get older," he said.
The study called VENTOUX was named after a famous mountain climb in the world-renowned Tour de France bike race. The researchers followed 106 male cyclists/triathletes aged 50 or older, who had no symptoms of heart disease. All had trained at least 10 hours a week for 15 years or more.
The participants underwent cardiovascular magnetic resonance (CMR) imaging, a specialized test that uses magnetic fields to produce detailed images of the heart. They also had an ECG recorder implanted under the skin of their chest that recorded every heartbeat for two years.
During an average follow-up of two years, researchers found:
almost half of the athletes (47.2%) showed signs of scarring on the left ventricle of the heart; and
about 3% of the athletes had sustained, potentially dangerous fast heart rate originating in the lower chambers of the heart, while 19% experienced shorter bursts of rapid heartbeats.
Any participant who developed a potentially harmful rhythm was contacted urgently to assess symptoms and advised to seek independent medical attention.
"We did not expect the association between scarring and dangerous rhythms to be this strong," Swoboda said. "Similar findings have been reported in patients with heart muscle disease, however, we did not expect this in healthy, performance athletes."
He urged any athlete who experiences chest pain, dizziness or palpitations during activity to seek treatment and also advised, "It's important that everyone involved in sports knows CPR and how to use an automated external defibrillator."
Although the annual incidence of sudden cardiac death during sports varies among studies, the annual rate of abnormal heart rhythms detected in this study were considerably higher than rates among the general population.
The study has several limitations such as including a small number of very select participants. The findings may not apply to people not represented in the study: women, non-athletes or non-European cyclists. In addition, the findings could not differentiate whether the cardiac scarring itself was the cause of irregular heart rhythms or if it was a marker for a separate underlying process.
Future research will examine women, the authors said.
Study details, background and design:
The study enrolled 106 athletes from sporting organizations in the U.K.
The athletes self-reported their training history, and those with pre-existing heart conditions were excluded.
Upon entry into the study, participants underwent clinical assessments, imaging and had a loop recorder implanted. The loop recorder monitored for ventricular arrhythmia for two years.
A comparative group of age-matched, male, non-athletes was enrolled to undergo the same imaging.
Each participant was asked to continue with their normal daily activities and sporting habits.
The study was funded by the British Heart Foundation, the National Institute for Health and Care Research, Leeds Biomedical Research Centre and Leeds Clinical Research Facility.
Co-authors, disclosures are listed in the manuscript.
Studies published in the American Heart Association's scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association's policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content. Overall financial information is available here.
Additional Resources:
Available multimedia is on right column of release link
After 7:01 pm ET on July 17, 2025, view the manuscript online.
AHA health information: What is an Arrhythmia?
AHA health information: Watch an animation of ventricular fibrillation
AHA health information: Cardiac Arrest vs Heart Attack
Follow AHA/ASA news on X @HeartNews
Follow news from the AHA's Circulation: Cardiovascular Imaging journal @CircImaging
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About the American Heart Association
The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public's health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.
For Media Inquiries and AHA/ASA Expert Perspective: 214-706-1173
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