Italian Cardiological Guidelines (COCIS) for Competitive Sport Eligibility in athletes with heart disease: update 2020

Abstract

Since 1989, SIC Sport and a FMSI, in partnership with leading Italian Cardiological Scientific Associations (ANCE, ANMCO and SIC) have produced Cardiological Guidelines for Completive Sports Eligibility for athletes with heart disease (COCIS -- 1989, 1995, 2003, 2009 and 2017). The English version of the Italian Cardiological Guidelines for Competitive Sports Eligibility for athletes with heart disease was published in 2013 in this Journal. This publication is an update with respect to the document previously published in English in 2013. It includes the principal innovations that have emerged over recent years, and is divided into five main chapters: arrhythmias, ion channel disorders, congenital heart diseases, acquired valve diseases, cardiomyopathies, myocarditis and pericarditis and ischemic heart disease. Wherever no new data have been introduced with respect to the 2013 publication, please refer to the previous version. This document is intended to complement recent European and American guidelines but an important difference should be noted. The European and American guidelines indicate good practice for people engaging in physical activity at various levels, not only at the competitive level. In contrast, the COCIS guidelines refer specifically to competitive athletes in various sports including those with high cardiovascular stress. This explains why Italian guidelines are more restrictive than European and USA ones. COCIS guidelines address ‘sports doctors’ who, in Italy, must certify fitness to participate in competitive sports. In Italy, this certificate is essential for participating in any competition.

WITHDRAWN: Sudden death of an athlete due to concealed arrhythmogenic cardiomyopathy: Why preparticipation screening did fail

“…The 2017 Italian recommendations for cardiovascular eligibility to competitive sport (COCIS) emphasize that exclusion of an underlying heart disease is the most important goal of the diagnostic work-up of athletes with PVBs [19]. In addition to second-line investigations (maximal exercise testing, 24-h ambulatory ECG monitoring and echocardiography), the guidelines suggest to perform CMR in athletes with PVBs with a RBBB/superior axis pattern, i.e.…”

Congenital Heart Disease: Growth Evaluation and Sport Activity in a Paediatric Population

“…In Italy, the Cardiological Organizing Committee for Sport Suitability allows moderate to vigorous physical activities after an extensive cardiological evaluation. The latter is individualised according to the severity of CHD and its correction and can include cardiac ultrasound, ECG, and even cardiopulmonary exercise testing and cardiac MRI in severe cases [ 32 ]. At our institution, we followed the latter instructions.…”

An Extremely Rare Presentation of Four Coronary Anomaly Patterns Originating from the Right Coronary Sinus

“…Another explanation is that he was more sedentary and was never involved in competitive sports. The Italian cardiological guidelines for competitive sport eligibility in athletes with heart disease [ 10 ] do recommend further workup that may include a CTA in symptomatic athletes. Had he been involved in sports, his coronary anomaly could have been diagnosed at an earlier time and could have been corrected with surgery.…”