Study Indicates Low Cardiac Risk For Elite Level Athletes With Genetic Heart Disease

Ninety-five percent of athletes with a diagnosed and treated genetic heart disease experienced no disease-triggered cardiac events, including cardiogenic fainting or seizures, ICD shocks, sudden cardiac arrest or sudden cardiac death, according to a retrospective, multicenter study presented at ACC.23/WCC.

Katherine A. Martinez, et al., analyzed health records from 76 elite athletes (28% female with a mean age of 19.0 years at diagnosis and 19.9 years at return-to-play) with a genetic heart disease playing at the Division I or professional level. Of them, 53% of patients had hypertrophic cardiomyopathy and 26% had long QT syndrome. Researchers noted that 63% of patients were asymptomatic prior to diagnosis, with 53% diagnosed after an abnormal cardiac evaluation, 24% due to cardiac symptoms, 9% from a family history of sudden cardiac death or genetic heart disease, 9% due to other symptoms and 5% from an unrelated event.

All athletes assessed underwent a return-to-play protocol including comprehensive evaluation with risk stratification, establishing a genotype- and phenotype-tailored treatment program and implementing a proper athlete-specific return-to-play plan.

Following the protocol, 96% of athletes opted to return-to-play, with 5% remaining disqualified from their team despite achieving return-to-play approval. During an average seven year follow up, 4% of athletes experienced a non-lethal cardiac episode, where fainting was the most common event. One patient received an appropriate ICD shock.

“This initial data set offers a story of hope and encouragement,” said Martinez. “With shared decision-making and appropriate risk stratification by an expert, we expect anybody of any age can live and thrive despite their diagnosis.”

A comprehensive return-to-play protocol is essential for an athlete’s safe return-to-play and must include adherence to prescribed treatments, a personal AED, annual follow-ups and risk evaluation, and open communication with school, organization, athletic directors and/or medical staff.

Clinical Topics: Arrhythmias and Clinical EP, Congenital Heart Disease and Pediatric Cardiology, Sports and Exercise Cardiology, SCD/Ventricular Arrhythmias, Congenital Heart Disease, CHD and Pediatrics and Arrhythmias, Sports and Exercise and Congenital Heart Disease and Pediatric Cardiology

Keywords: ACC Annual Scientific Session, ACC23, Return to Sport, Death, Sudden, Cardiac, Sports, Heart Defects, Congenital

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