Effect of Exercise on Outcome after Ventricular Tachycardia Ablation in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy

Abstract

Competitive sports and intensive exercise are associated with adverse outcomes in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). This study aimed to assess the role of exercise on long-term results of radiofrequency catheter ablation (RFCA) therapy of ventricular tachycardia (VT) in patients with ARVD/C. Exercise participation was evaluated by telephone or in-person interviews in patients from our ARVD/C registry with previous VT ablation (38 patients, 26 males, age 52.6±14.1years). Of 38 patients, 30 were involved in sports activities before RFCA. Only the minority of our patient population (21.1%) had a sedentary lifestyle before RFCA; 42.1 and 36.8% reported recreational or competitive sports, respectively. During the follow-up period of 52.5±31.4 months, 23 of the total 38 patients with previous RFCA (60.5%) remained free from VT recurrence. In univariate and binary logistic regression analysis, only advanced age was significantly associated with VT recurrence, with a hazard ratio of 1.15, and 95% confidence interval 1.05–1.26 (p=0.004). The results of our observational study indicate that recreational sports do not impair long-term results after RFCA treatment compared with a sedentary lifestyle. Furthermore, the dynamic component of recreational exercise did not affect the outcome of VT ablation in our patient population. Recreational exercise at low to moderate intensity is not associated with an increased risk for VT recurrence after catheter ablation in patients with ARVD/C.

Facts and Gaps in Exercise Influence on Arrhythmogenic Cardiomyopathy: New Insights From a Meta-Analysis Approach

“…Some interesting series have helped to define the specific risk of physical activity in mutation carriers not exhibiting an overt ACM phenotype, concluding that exercise also promotes disease progression in this scenario (41,42). Others have assessed the effect of exercise restriction to find out an improvement in outcomes (43,44) regardless of the previous level of training (45). Although more exercise causes more electrical and/or structural progression (41,43,(46)(47)(48), the intensity rather than the duration of the exercise performed seems to play a more determinant role.…”

Physical Exercise and Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia

“…The Medical Subject Headings (MeSH) terms used and combined were “Arrhythmogenic Right Ventricular Dysplasia” [Mesh] AND “Exercise” [Mesh], which resulted in 72 records. Seven animal or preclinical[ 15 16 17 18 19 20 21 ] and 18 clinical studies[ 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 ] were selected and discussed. [ Table 1 ] presents the definitions of terms used in the identified studies.…”

“…Advanced age was the only variable that was significantly associated with the recurrence of ventricular tachycardia (hazard ratio 1.15, 95% CI 1.05–1.26, P = 0.004). [ 24 ]…”

Sport activity in patients with cardiomyopathies: a review

“…29 Furthermore, intense exercise has been recognized as a modulating factor promoting phenotypic penetrance and disease progression in animal studies and carriers of ACM gene variants. [30][31][32][33][34][35][36][37] Systematic preparticipation screening for sports activity reduces the risk of SCD associated with 'classic' ACM variants (right dominant or biventricular) due to its capability to identify asymptomatic patients by abnormal ECG or ventricular arrhythmias. 38 For this reason, the incidence of SCD from 'classic' ACM has decreased in the last few years.…”