Frequently Asked Questions: About the Programme

ABOUT FIFPRO x IDOVEN PLAYER HEART MONITORING SERVICE PILOT PROGRAMME

WHAT IS THE FIFPRO x IDOVEN PLAYER HEART MONITORING PROGRAMME?
FIFPRO and IDOVEN have decided to create a strategic partnership to improve player health safeguards in the context of cardiac arrest and other heart-related risks. The aim of the FIFPRO x IDOVEN Player Heart Monitoring Service pilot programme is to provide player unions and players with a complimentary resource to perform voluntary heart monitoring. It gives players’ the opportunity to access additional resources and offers technology-based thought-leadership solutions to redefine the way cardiac arrhythmias are detected.

WHAT IS THE ADDED VALUE FOR UNIONS AND PLAYERS?
The objective of the FIFPRO x IDOVEN Player Heart Monitoring Service is to provide additional heart monitoring and screening services to a) players who have otherwise no access to heart monitoring or screening and b) complement existing medical health and safety requirements for players (e.g. mandatory ECGs or echocardiography).

DOES THE FIFPRO x IDOVEN PLAYER HEART MONITORING SERVICE REPLACE MANDATORY SCREENINGS BY CLUBS OR COMPETITION ORGANISERS?
No. The FIFPRO x IDOVEN Heart Monitoring Service provides an additional resource and safety net without replacing the duty of care by the direct employer or the competition organiser. Minimum standards for medial health safety protocols must still require mandatory heart monitoring and screenings for players. However, it remains a fact that in many playing markets across the world, players have no regular mandatory access to such health and safety services. Therefore, this pilot programme also serves as a stepping stone to advance the accessibility of regular heart monitoring and screening services which should ultimately be implemented into collective agreements and/or domestic medical protocols.

WHO IS IDOVEN?
IDOVEN is a health technology company based in Spain advancing early detection and intervention for cardiovascular diseases. The company has developed an integrated solution for heart monitoring, leveraging artificial intelligence (AI) to identify arrhythmias and cardiac abnormalities from the electrical signals generated by the heart, and detect heart problems at an early stage. IDOVEN's cardiology and electrophysiology specialists have designed an exclusive monitoring protocol for high-performance athletes for the optimal evaluation during the season (training or competition). The protocol also covers relevant aspects such as recovery, sleep, daily stress and other activities that are not integrated by conventional monitoring systems (e.g. stress test) and is fully adaptable to all player profiles.

HOW LONG WILL THE PILOT PROGRAMME LAST?
The pilot programme will initially last for one season with the option to be extended in case of a successful implementation. FIFPRO will provide the heart monitoring service to 15 player unions for the distribution to both male and female professional players. Each participating player union will be able to distribute the Player Heart Monitoring Service to about 18 players. Each player will have access to heart monitoring (with the duration of 24 hours) during pre-season and an additional monitoring during competition.

WHAT IS HEART DISEASE AND WHY IS IT IMPORTANT TO IDENTIFY IT EARLY?
Heart disease refers to a wide range of conditions that affect the heart, including for instance blood vessel disease (coronary artery disease), heart muscle disease and inflammation/infection, heart rhythm problems (also called arrhythmias) and heart problems you are born with. Heart disease is a leading cause of death but it can be prevented through a heart-healthy lifestyle that includes a healthy diet, no use of tobacco and regular physical activity. Such a heart-healthy lifestyle is generally adopted among professional footballers. But it remains essential to identify heart problems as early as possible with players that they are born with such conditions, or heart problems that they develop during their career. Elite athletes such as professional footballers are also exposed to specific risks due to their profession. Therefore, heart monitoring as facilitated by the FIFPRO x IDOVEN Player Heart Monitoring Programme should be performed regularly.

WHO IS ELIGIBLE TO PARTICIPATE IN THE PILOT PROGRAMME?
All the players, without consideration of gender, age or health conditions are in principle eligible to participate in the programme. Nevertheless, in line with FIFPRO policies, it is required to select 50% female players (for the union representing female players).
It is recommended that selected players should be able to fill the medical questionnaire and surveys in English, French or Spanish.

IN WHICH CIRCUMSTANCES SHOULD THE PLAYERS DO THE MONITORING?
The best circumstances to do the 24 hours monitoring is to pick a day as normal as possible for the players. It is better to have heterogeneous data recorded (training and recovery) to have a maximum of information available to be analysed. The more data is collected, the more precise the report will be.

HOW CAN I APPLY THE DATA OBTAINED TO IMPROVE MY HEALTH?
With the FIFPRO x IDOVEN Player Heart Monitoring Report, you can easily delve into how your heart adapts to different training loads, work stress or how it recovers during rest to know if it is adapting appropriately to your pace of life, finding possible alterations, identifying cardiac abnormalities in the early stages and the ability to investigate if intervention is required.

HOW CAN I APPLY THE INFORMATION OBTAINED ABOUT MY HEART TO IMPROVE MY ATHLETIC PERFORMANCE?
The FIFPRO x IDOVEN Player Heart Monitoring Service will not only study if your heart is healthy, but it can also help you to improve your sports performance. The device that monitors your heart also records your physical activity using an accelerometer. We are able to see how your heart adapts to different types and loads of training while you are preparing for a competition or trying to improve your performance.

WHAT IS THE DIFFERENCE BETWEEN THE FIFPRO X IDOVEN PLAYER HEART HOLTER MONITORING AND A ECG (STRESS) TEST?
The FIFPRO x IDOVEN Player Heart Monitoring Service is a different but complementary service. The main differences are:

• Measuring time and number of heartbeats:
  FIFPRO x IDOVEN Player Heart Monitoring Service analyses the heartbeat continuously for 24 hours while a stress test takes about 8-20 minutes depending on the protocol used and the physical condition of the patient. The number of heartbeats monitored for a person in a stress test in those 8-20 minutes is about 2000 beats. The average number of heartbeats recorded and analysed by the IDOVEN medical-sports team is 100,000 beats per person in a 24 hour study.
• Big Data consists of analysing data sets so large and complex - in this case heartbeats - that they require non-traditional computer processing applications to treat them properly, thus extracting value from this stored information and formulating predictions through the observed patterns. IDOVEN’s medical and engineering team is developing artificial intelligence algorithms that help doctors process all that information.
• Laboratory study and real life study:
  The objective of FIFPRO x IDOVEN is to monitor the real activity of players who want to know the state of their heart wherever they live. We do not only monitor training or a specific effort, but we also monitor everything that happens in the heart of an athlete's day-to-day life (training anywhere, rest, work, social life...). In this way, we can understand what happens in the athlete's heart, how he/she recovers, what alterations he/she has (if any) and how his/her heart acts after different types of effort. With the FIFPRO x IDOVEN Player Heart Monitoring Service you will be able to know at what heart rate you sleep, how fast or slow your heart recovers after effort or how it acts in a work situation with stress or lack of sleep. We monitor your whole day, not just a specific moment of it, as usually done during a stress test.
• Monitoring of all types of training:
  With the FIFPRO x IDOVEN Player Heart Monitoring Service you can monitor all types of non-aquatic training and not just one-off training. Stress tests monitor how your heart acts when it is put under incremental stress for 15 minutes but with the FIFPRO x IDOVEN Player Heart Monitoring Service you can monitor all types of workouts. From long runs of any length (cycling outings, long distance mountain training or specific resistance training) to shorter training sessions with a higher intensity (usual training in the city, High Intensity Interval Training (HIIT), series, slopes, strength training...). You will be able to find out how your heart works in all types of training and how it recovers after each effort.
• Recovery monitoring:
  It is known by all athletes that recovery and rest is part of training and that our performance can be closely related to how we rest and how our heart recovers after effort. With the FIFPRO x IDOVEN Player Heart Monitoring Service we can monitor what happens to our heart during the recovery process and nightly rest. This data will help us to know if the training we are doing is correct or if we are over-trained and our organism does not assimilate the training well. Obviously with a stress test these data cannot be analysed since usually in the doctor's office recovery after stress is monitored for 2-5 minutes.

INCENTIVES AND IMPORTANT INFORMATION FOR THE PLAYERS AND PROGRAMME ROLL-OUT

WHY SHOULD I PARTICIPATE IN THE PILOT PROGRAMME?
When participating in the programme, you will have access to 24-hour heart monitoring. This is an exceptional service that would help you to know more about your heart condition and about how to improve your performances. By participating in the pilot, you are also contributing to study and research on football players' heart conditions.

HOW WILL MY HEART DATA BE ANALYSED?
The patterns of thousands of heartbeats and cardiac electrical signals emitted by your heart during different activities are analysed with IDOVEN’s artificial intelligence algorithms and reviewed by a EU board-certified cardiologist. This allows our medical team to detect with great precision the behaviours of your electrocardiogram for 24 hours to screen for possible alterations.

WHY SHOULD I PARTICIPATE IF MY CLUB AND THE MEDICAL PROTOCOLS ALREADY PROVIDE FOR AN ECG STRESS TEST AND/OR AN ECHOCARDIOGRAPHY?
In comparison to the regular ECG stress test, the FIFPRO x Idoven Player Heart Monitoring Service provides additional data on your heart. Even for players that have regular ECG stress tests, this can provide important additional information. Further, by participating, you are contributing to study and research on football players' heart conditions to improve a safe playing environment.

WHAT IS THE ADDED VALUE OF THE FIFPRO X IDOVEN PLAYER HEART MONITORING SERVICE IF I HAVE NO ACCESS TO ANY HEART MONITORING SERVICES BY CLUB?
The FIFPRO x IDOVEN Player Heart Monitoring Service guarantees access to detailed remote monitoring under the surveillance of a cardiac expert. This does not replace the need for ECGs at the club and competition level but it provides you with the second best option, in case you are not covered by such services in your playing environment. The FIFPRO x IDOVEN Player Heart Monitoring Service would help you to know more about your heart condition and about how to improve your performances. Also, it remains essential to identify as early as possible potential heart problems you might be born with or heart problems that you might develop during your career.

WHAT ARE THE LIMITATIONS OF THE FIFPRO X IDOVEN PLAYER HEART MONITORING SERVICE?
The FIFPRO x IDOVEN Player Heart Monitoring Service does not replace the requirement from your employer to guarantee regular heart screenings. It serves as an additional resource and safety net for you.

WILL I RECEIVE SUPPORT IN CASE THE FIFPRO X IDOVEN PLAYER HEART MONITORING SERVE DETECTS ANY IRREGULARITIES?
In case of heart abnormalities are identified, you can always contact FIFPRO to get support and guidance (Vincent Gouttebarge, FIFPRO Chief Medical Officer - [email protected]). Then, FIFPRO will initiate your after-care by referring you to a medical centre for further examination via ECG and/or echocardiography. The costs for this further examination will be covered by FIFPRO.

HOW DO I PARTICIPATE AND GET STARTED?
Once you have been selected by your union to be part of the pilot programme, your union’s main contact will inform you directly about all of the steps - from getting your device to using it properly, and returning it at the end of the monitoring.

WILL IT COST ME ANYTHING TO BE PART OF THE PROGRAMME?
The use of the service for the selected players is free of charge. The costs are entirely covered by FIFPRO (the monitoring service itself and the international shipment) and your union (local logistic and national shipments).

WHAT SERVICES AND CAN I EXPECT IF I PARTICIPATE IN THE PILOT PROGRAMME?

The players participating will receive :

• A health questionnaire and consent form prior to the start of the monitoring
• 24 hours monitoring, twice (one during pre-season, the other during the season)
• A personal report delivered after each monitored period with analysis of their heart conditions and additional recommendation to improve their performances

You will also be asked to complete a feedback survey to improve the experience of all future players that may benefit from this programme.

CAN I WITHDRAW FROM THE PROGRAMME?
You are of course free to withdraw from the programme anytime you want. In this case, fees could apply. Please check the conditions with your union.

I HAVE A DIFFERENT QUESTION. HOW CAN I CONTACT THE ADMINISTRATORS OF THE PROGRAMME?
Your union is responsible for the roll-out of the project and the local logistics. Contact your local coordinator for any questions related to these points. For any other question or if you don't find your answer here, please contact us: [email protected]