Harmful Effects of Exercise Intensity and Exercise Duration in Patients With Arrhythmogenic Cardiomyopathy

Lie, Øyvind; Dejgaard, Lars A.; Saberniak, Jørg; Rootwelt, C; Stokke, Mathis Korseberg; Edvardsen, Thor; Haugaa, Kristina H.

doi:10.1016/j.jacep.2018.01.010

Cited by 92 publications

(95 citation statements)

References 27 publications

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“…Wang et al from the same research group reported a decreased risk for ventricular arrhythmias by reduced exercise dose (intensity × duration) in ARVD/C patients with and without desmosomal mutation [25]. Lie et al from Oslo University Hospital reported high-intensity exercise as a strong and independent marker of life-threatening ventricular arrhythmias in ARVD/C patients, independent of exercise duration [26].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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“…Endurance training in AC patients, especially high intensity exercise, has been associated with VAs, more severe RV dysfunction, LV dysfunction, and heart failure [68,69]. Conversely, the risk of VAs and mortality can be reduced by lowering exercise [42,66,69,70]. A dose-dependent relationship between exercise exposure and the disease penetrance was demonstrated in different categories of AC patients.…”

Section: Impact Of Sports Activitymentioning

confidence: 97%

“…Kirchhof et al demonstrated that in heterozygous plakoglobin-deficient mice endurance training facilitated the development of RV abnormalities and VAs [67]. Endurance training in AC patients, especially high intensity exercise, has been associated with VAs, more severe RV dysfunction, LV dysfunction, and heart failure [68,69]. Conversely, the risk of VAs and mortality can be reduced by lowering exercise [42,66,69,70].…”

Section: Impact Of Sports Activitymentioning

confidence: 99%

Natural History of Arrhythmogenic Cardiomyopathy

Mattesi

Zorzi

Corrado

et al. 2020

JCM

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Arrhythmogenic cardiomyopathy (AC) is a heart muscle disease characterized by a scarred ventricular myocardium with a distinctive propensity to ventricular arrhythmias (VAs) and sudden cardiac death, especially in young athletes. Arrhythmogenic right ventricular cardiomyopathy (ARVC) represents the best characterized variant of AC, with a peculiar genetic background, established diagnostic criteria and management guidelines; however, the identification of nongenetic causes of the disease, combined with the common demonstration of biventricular and left-dominant forms, has led to coin the term of “arrhythmogenic cardiomyopathy”, to better define the broad spectrum of the disease phenotypic expressions. The genetic basis of AC are pathogenic mutations in genes encoding the cardiac desmosomes, but also non-desmosomal and nongenetic variants were reported in patients with AC, some of which showing overlapping phenotypes with other non-ischemic diseases. The natural history of AC is characterized by VAs and progressive deterioration of cardiac performance. Different phases of the disease are recognized, each characterized by pathological and clinical features. Arrhythmic manifestations are age-related: Ventricular fibrillation and SCD are more frequent in young people, while sustained ventricular tachycardia is more common in the elderly, depending on the different nature of the myocardial lesions. This review aims to address the genetic basis, the clinical course and the phenotypic variants of AC.

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“…Moreover, imaging studies revealed that left and right ventricular function was reduced and right ventricle volume enlarged in athletes when compared to non-athletes (Sen-Chowdhry et al, 2007). Interestingly, an apparent direct dose-response relationship has been established between exercise intensity and severity of AC phenotypes in AC-mutation carriers, where exercise intensity is more damaging than exercise duration (Lie et al, 2018a).…”

Section: Ac Penetrance Is Dependent On Physical Exercisementioning

confidence: 99%

Mechanotransduction and Adrenergic Stimulation in Arrhythmogenic Cardiomyopathy: An Overview of in vitro and in vivo Models

2020

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Harmful Effects of Exercise Intensity and Exercise Duration in Patients With Arrhythmogenic Cardiomyopathy

Abstract: High-intensity exercise was a strong and independent marker of life-threatening VA in AC patients, independent of exercise duration. AC patients could be advised to restrict their exercise intensity.

Cited by 92 publications

References 27 publications

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

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

Natural History of Arrhythmogenic Cardiomyopathy

Mechanotransduction and Adrenergic Stimulation in Arrhythmogenic Cardiomyopathy: An Overview of in vitro and in vivo Models

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