Safety of Sports Participation in Patients with Implantable Cardioverter Defibrillators:  A Survey of Heart Rhythm Society Members

Lampert, Rachel; Cannom, David S.; Olshansky, Brian

doi:10.1111/j.1540-8167.2005.00331.x

Cited by 102 publications

(66 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a 2006 retrospective survey of Heart Rhythm Society physician members, 4 >40% reported having at least 1 ICD patient in their practice participating in vigorous or competitive sports despite existing recommendations. No serious adverse events related to sports participation were reported.…”

Section: Clinical Perspective On P 2030mentioning

confidence: 99%

Safety of Sports for Athletes With Implantable Cardioverter-Defibrillators

et al. 2013

Self Cite

View full text Add to dashboard Cite

Background-The risks of sports participation for implantable cardioverter-defibrillator (ICD) patients are unknown. Methods and Results-Athletes with ICDs (age, 10-60 years) participating in organized (n=328) or high-risk (n=44) sports were recruited. Sports-related and clinical data were obtained by phone interview and medical records. Follow-up occurred every 6 months. ICD shock data and clinical outcomes were adjudicated by 2 electrophysiologists. Median age was 33 years (89 subjects <20 years of age); 33% were female. Sixty were competitive athletes (varsity/junior varsity/traveling team). A pre-ICD history of ventricular arrhythmia was present in 42%. Running, basketball, and soccer were the most common sports. Over a median 31-month (interquartile range, 21-46 months) follow-up, there were no occurrences of either primary end point-death or resuscitated arrest or arrhythmia-or shock-related injury-during sports. There were 49 shocks in 37 participants (10% of study population) during competition/practice, 39 shocks in 29 participants (8%) during other physical activity, and 33 shocks in 24 participants (6%) at rest. In 8 ventricular arrhythmia episodes (device defined), multiple shocks were received: 1 at rest, 4 during competition/practice, and 3 during other physical activity. Ultimately, the ICD terminated all episodes. Freedom from lead malfunction was 97% at 5 years (from implantation) and 90% at 10 years. Conclusions-Many athletes with ICDs can engage in vigorous and competitive sports without physical injury or failure to terminate the arrhythmia despite the occurrence of both inappropriate and appropriate shocks. These data provide a basis for more informed physician and patient decision making in terms of sports participation for athletes with ICDs.

show abstract

Section: Clinical Perspective On P 2030mentioning

confidence: 99%

Safety of Sports for Athletes With Implantable Cardioverter-Defibrillators

et al. 2013

Self Cite

View full text Add to dashboard Cite

show abstract

“…61 Results from the study showed that 76% of physicians recommended against contact sports, 45% recommended against competitive sports, and only 10% recommended against all activities more vigorous than golf or bowling. 61 The data showed that 70% of physicians reported patients in their practice were involved in some form of sporting activity. In 42% of practices, ≥1 patient with an ICD was competing in competitive sports, and of these, 22% had patients reporting ICD shocks during the activity.…”

Section: Sweeting Et Al Exercise In Genetic Heart Disease 183mentioning

confidence: 98%

“…61 Whether or not more vigorous exercise is beneficial for ICD patients, this study highlights an important point in that, although physicians recommended against participation in competitive sports, there were several individuals who chose to compete regardless. This leads to the question who should have the deciding vote regarding a patient's participation in exercisethe physician or the patient?…”

mentioning

confidence: 99%

Challenges of Exercise Recommendations and Sports Participation in Genetic Heart Disease Patients

Sweeting

Ingles

Ball

et al. 2015

Circ Cardiovasc Genet

View full text Add to dashboard Cite

16Low intensity, <4 METS. Moderate intensity, 4-6 METS. High intensity, >6 METS. HCM indicates hypertrophic cardiomyopathy; ICD, implantable cardioverterdefibrillator; LQTS, long QT syndrome; and METS, metabolic equivalent value.*Involves potential for traumatic injury, especially during times of impaired consciousness, for example, because of ICD shock. by guest on May 9, 2018 http://circgenetics.ahajournals.org/ Downloaded from Circ Cardiovasc GenetFebruary 2015 advising restrictions on certain physical activities depending on the underlying genetic heart disease. Both the American College of Cardiology (ACC) in conjunction with the American Heart Association (AHA) and the European Society of Cardiology (ESC) have sought to address this issue and have released various recommendation documents, a summary of which is provided in Figure 1. 14,15,29 Although there is a paucity of strong evidence to guide these recommendations, there is a consensus view that maintaining low to moderate intensity activity is important to avoid health burdens associated with physical inactivity.The ACC/AHA recommendations seek to address the conflict between the risk of high-intensity exercise and the risk of a sedentary lifestyle, although also acknowledging the desire of patients to participate in exercise. 15 They specifically focus on patients involved in recreational sports (ie, noncompetitive athletes) and reinforce that patients with a genetic heart disease can still gain some benefit from exercise and sports participation, highlighting the importance of maintaining physical and psychological well-being in this young patient group. Furthermore, an additional recommendations document has focused specifically around competitive athletes engaged in systematic training and competition, where there is emphasis on achievement. 30 An underlying difference is assumed between competitive athletes and recreational participants that necessitates separate recommendations, namely, that nonathletes have greater opportunity to exert reasonable control over their level of exercise and therefore are more likely to reliably detect cardiac symptoms and wilfully terminate physical activity. 15 The ACC/AHA recommendations for those involved in noncompetitive activities categorize a selection of common sports based on the degree of physiological exertion, measured in METS. Recommendations are made for HCM, LQTS, ARVC, and Brugada syndrome patients for each sport, taking into account the characteristics of each condition. Table 1 illustrates a selection of sports and activities, their corresponding intensity measured in METS (categorized according to low, moderate, and high MET values) and the recommendation regarding participation for individuals with HCM and LQTS. The core principle underlying this document is that patients with genetic cardiovascular disease can safely participate in most forms of recreational exercise judged to be of moderate or low intensity. 15 Avoidance of several activities and environmental factors that may increase the lik...

show abstract

“…Clearly, this will vary as a function of the patient, the patient's underlying condition, the severity of the patient's illness, and the potential impact of an activity (such as driving) on others. Physician recommendations to ICD patients regarding sports participation vary widely; one survey of electrophysiologists reported 76% recommending avoidance of contact and 45% recommending avoidance of competitive sports 119 ; in the same study, shocks were cited commonly, but adverse effects were rare. Nonetheless, the 36th Bethesda Conference task force strongly suggests that athletes with either primary or secondary prevention ICDs should be disqualified from all competitive sports except for those of low intensity; pacemakerdependent patients are advised against participating in most competitive sports that potentially involve body trauma.…”

Section: Participation In Sports and Driving By The Patient With A Dementioning

confidence: 99%

Contemporary Pacemaker and Defibrillator Device Therapy

Schoenfeld

2007

Circulation

View full text Add to dashboard Cite

Safety of Sports Participation in Patients with Implantable Cardioverter Defibrillators:  A Survey of Heart Rhythm Society Members

Abstract: Physician recommendations for sports participation for patients with ICDs varies widely. Many patients with ICDs do participate in vigorous and even competitive sports. While shocks were common, significant adverse events were rare.

Cited by 102 publications

References 30 publications

Safety of Sports for Athletes With Implantable Cardioverter-Defibrillators

Safety of Sports for Athletes With Implantable Cardioverter-Defibrillators

Challenges of Exercise Recommendations and Sports Participation in Genetic Heart Disease Patients

Contemporary Pacemaker and Defibrillator Device Therapy

Contact Info

Product

Resources

About

Safety of Sports Participation in Patients with Implantable Cardioverter Defibrillators: A Survey of Heart Rhythm Society Members

Abstract: Physician recommendations for sports participation for patients with ICDs varies widely. Many patients with ICDs do participate in vigorous and even competitive sports. While shocks were common, significant adverse events were rare.

Cited by 102 publications

References 30 publications

Safety of Sports for Athletes With Implantable Cardioverter-Defibrillators

Safety of Sports for Athletes With Implantable Cardioverter-Defibrillators

Challenges of Exercise Recommendations and Sports Participation in Genetic Heart Disease Patients

Contemporary Pacemaker and Defibrillator Device Therapy

Contact Info

Product

Resources

About

Safety of Sports Participation in Patients with Implantable Cardioverter Defibrillators:  A Survey of Heart Rhythm Society Members