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From rest and sleep to work and workouts, our heart has to adapt its activity to meet the demands of the body during the day. The autonomic nervous system (ANS) plays a pivotal role in regulating our heart rate, cardiac contractility and blood pressure. Sympathetic hyperactivity interacts with renin-angiotensin-aldosterone system, increases blood pressure as well cardiac preand afterload and worsens heart failure (29, 52). The autonomic nervous system directly affects cardiac electrophysiology modulating the intrinsic heart rate generated by the sinoatrial node, as it changes ion channel currents, their expression and consequently action potential duration (40). Measurement of resting as well as exercise heart rate has been established throughout decades in team sports and endurance athletes to estimate ANS activity and this has provided vital insights in the connection between the autonomic nervous Prof. Dr. Stefan Brunner Ludwig-Maximilians University Munich (LMU) University Hospital Munich – Campus Innenstadt, Department of Medicine I Ziemssenstraße 1, 80336 Munich, Germany : stefan.brunner@med.uni-muenchen.de SCHLÜSSELWÖRTER: Periodic Repolarization Dynamics, Deceleration Capacity, Trainingssteuerung, Risikostratifizierung, plötzlicher Herztod, Herzfrequenzvariabilität

Routine heart rate-based and novel ECG-based biomarkers of autonomicnervous system in sports medicine