Update on Sports Participation for Athletes with Implantable Cardioverter Defibrillators

Abstract

Prior statements have recommended restriction from competitive sports participation for all athletes with ICDs. Recent data, however, suggests that many athletes can participate in sports without adverse events. In the ICD Sports Registry, 440 athletes, aged 8-60 years, 77 of which were high-level interscholastic athletes, who had continued to practice sports, were prospectively followed for 4 years, with no deaths or failures to defibrillate during practice, and no injuries related to arrhythmia or shock during sports. Shocks did occur, for ventricular and supraventricular arrhythmias. While more athletes received shocks during physical activity than at rest, there were no differences between competition or practice, versus other physical activity. Programming with higher rate cutoffs and longer durations was associated with fewer inappropriate shocks, with no increase in syncope. Based on this study, current recommendations now state that returning to competition may be considered for an athlete with an ICD. In considering this decision, the underlying disease and type of sport should be discussed, and shared decision-making between doctor, patient, and often family, is critical.

(Athlete with pacemaker or cardioverter-defibrillator)

“…Pouze u dvou sportovců se vyskytla komorová arytmie pod terapeutickou zónou, avšak bez synkopy, pouze s palpitacemi. 16 Tato studie na nastavení ICD sportovců je ve shodě se studií s podobným přístupem u všeobecné populace. 17 Sportovec musí být v problematice ICD co nejvíce vzdělán, aby předešel komplikacím.…”

Physical Activity, Exercise and Sport: A Five-Star Path for a Better Cardiovascular Health

“…Authored by Dr. Rachel Lampert from Yale University (United States), the first review study presents the results of the analysis of updated data, derived from an important registry, on sports participation for athletes using implantable cardiac defibrillators, and also discusses the issue of shared-decision making. 14 The second paper presents very practical information for cardiologists who see healthy and unhealthy athletes and practitioners, about the use of wrist monitors and smartphone apps to measure exercise heart rate. Other important topics are covered in three non-systematic reviews and include: sex differences in sudden death during sports and exercise, impact of exercise training on cardiovascular and autonomic responses and the role of exercise training in the management of erectile dysfunction.…”