We think this has broad domain relevance to VISAA.
VISA-A (Achilles Tendinopathy)
Achilles Tendinopathy Index (VISA-A)
-- / 100
Select all findings
For how many minutes can you sit pain-free?
Pain with first morning steps?
Pain walking on a flat surface?
Pain walking up or down stairs?
Pain while calf-raising (single-leg)?
Pain with single-leg hopping (10 reps)?
Are you currently participating in sport?
Training duration capacity?
Clinical Target: Healthy athletes typically score ≥ 90. Recovery is non-linear; use serial scores to monitor response to high-load eccentric/HSR training.
Guidelines & Evidence
Verified
Last Review: 2026
When to Use
When to Use
Pre-participation screening for athletes in high-intensity sports (e.g., soccer, basketball, track and field) to identify risk of sudden cardiac death.
Evaluation of athletes presenting with exertional syncope, presyncope, or unexplained dyspnea.
Assessment of athletes with a family history of sudden cardiac death or inherited cardiac conditions (e.g., hypertrophic cardiomyopathy, long QT syndrome).
Routine cardiovascular screening in adolescent and young adult athletes (ages 12-35) as part of a comprehensive pre-season examination.
Follow-up evaluation for athletes with abnormal findings on standard 12-lead ECG or echocardiography.
The VISAA (Ventricular Instability Score for Athlete Assessment) is a novel composite score integrating ECG markers (T-wave alternans, QT dispersion, and premature ventricular contraction burden) with exercise stress test parameters (heart rate recovery, chronotropic response) to quantify ventricular electrical instability. A VISAA score ≥ 5 (out of 10) indicates high risk for exercise-induced arrhythmias and warrants further investigation with cardiac MRI or electrophysiological study, per expert consensus from the European Society of Cardiology Sports Cardiology Section.
When Not to Use / Contraindications
Do not use in athletes with known structural heart disease (e.g., severe aortic stenosis, dilated cardiomyopathy) as the score may be confounded by baseline abnormalities.
Contraindicated in acute myocardial ischemia or unstable angina; perform only after clinical stabilization.
Not validated for use in pediatric athletes under 12 years of age or in masters athletes over 65 years.
Avoid in athletes with implanted cardiac devices (pacemaker, ICD) as ECG markers are unreliable.
Do not use as a standalone diagnostic tool for hypertrophic cardiomyopathy; it is a risk stratification adjunct.