New Recommendations May Allow Some Athletes With CVD to Compete

Athletes with irregular heart beat caused by Long QT syndrome and those with an implanted medical device may safely play competitive sports, according to new recommendations from the ACC and American Heart Association (AHA) published Nov. 2 in the Journal of the American College of Cardiology.

The recommendations apply only to athletes diagnosed with cardiovascular disease who participate in competitive sports directed by a coach, such as football, basketball, baseball and others. They do not apply to those who occasionally play sports for fun or exercise.

Previous recommendations stated that the risk of sudden cardiac death was too high in athletes with Long QT syndrome or with heartbeat disorders treated by an implanted device, but new research indicates that the risk is lower than previously thought. These athletes may now be able to compete with the approval of their health care provider.

"These recommendations are intended to help health care providers and competitive athletes make individualized decisions based on the most current scientific research, the patient’s understanding of their risk and the health care provider’s clinical judgment, but are not intended to establish absolute mandates or to make the general medical (and legal) standard of care applicable to all competitive athletes," says Barry Maron, MD, FACC, co-chair of the writing committee. "It should be noted that the guidance for patients with hypertrophic cardiomyopathy has not changed – we still recommend avoiding intense competitive sports for people who have this condition."

The statement also provides recommendations for evaluating other congenital, genetic and acquired cardiac conditions that could increase the risk of sudden cardiac arrest in competitive athletes. To calculate the risk of sudden cardiac death, the ACC/AHA panel analyzed reports on competitive athletes with different types of cardiovascular disease. It is important to note that the ACC/AHA have not changed their screening recommendations, and continue to recommend that physicians use a 14-element check list for screening young people for congenital and genetic heart disease.

"The ultimate incentive is to prevent sudden cardiac death in the young, although it is also important not to unfairly or unnecessarily remove individuals from a healthy athletic lifestyle," says Douglas P. Zipes, MD, MACC, co-chair of the statement writing group. "The panel recognizes and strongly supports the well-documented health benefits of exercise, with regular physical activities encouraged for those individuals who have been removed from organized competitive athletics."

Clinical Topics: Arrhythmias and Clinical EP, Congenital Heart Disease and Pediatric Cardiology, Heart Failure and Cardiomyopathies, Sports and Exercise Cardiology, Implantable Devices, Genetic Arrhythmic Conditions, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Congenital Heart Disease, CHD & Pediatrics and Arrhythmias, Sports & Exercise and Congenital Heart Disease & Pediatric Cardiology

Keywords: Arrhythmias, Cardiac, Athletes, Baseball, Basketball, Cardiomyopathy, Hypertrophic, Football, Death, Sudden, Cardiac, Long QT Syndrome, Sports

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