Although the American College of Cardiology and the European Society of Cardiology now advise people with implantable cardioverter – defibrillators (ICDs) not to participate in vigorous sports, a new study offers strong support for people with ICDs who want to take part in sports. Although a large number of people with ICDs are elderly heart failure patients who are unlikely to want to participate in sports, ICDs are also implanted in young and otherwise healthy people with genetic diseases that leave them at high risk for lethal arrhythmias.
Now findings from the ICD Sports Safety Registry, published inCirculation, provide vital new information about this important topic. The registry, which was performed with the assistance of patient advocacy groups, included 372 ICD patients between 10 and 60 years of age who participated in sports more vigorous than golf or bowling. The most common reasons for having an ICD among people in the registry were long-QT syndrome in 73 people, hypertrophic cardiomyopathy in 63 people, and arrhythmogenic right ventricular cardiomyopathy in 55. 60 subjects were college age or younger who took part in competitive sports.
The main finding of the study was reassuring: not one participant died, needed to be resuscitated or suffered a severe arrhythmia-related injury while playing sports during the average of two and one-half years that patients were followed in the study. In addition:
- 77 people had 121 shocks during the course of the study,
- 40 people had at least 1 inappropriate shock,
- 36 people had shocks during competition or practice,
- 29 people had shocks during other physical activity, and
- 23 people had shocks during rest.
The study authors discussed the complex effect of ICDs on quality-of-life in this group:
Healthy college athletes have higher physical, emotional, and social functioning and quality-of-life scores than non-athletes, yet athletes sidelined with an injury score lower in all of these domains than both active athletes and non-athletes. Many adolescents with ICDs and their physicians report restriction from sports and the resultant feeling of not being normal as one of the most important negative aspects of their device.
Limiting sports participation might also have a paradoxical impact on survival. The authors observed that although exercise can trigger lethal arrhythmias in the short term, “the better conditioned the individual, the less likely overall he or she is to die suddenly.” But it is not known whether this holds true for younger people with arrhythmogenic conditions.
The authors concluded that “a blanket recommendation against competitive sports for all patients with ICDs is not warranted. There are risks and benefits of sports participation. However, neither do these data suggest that all sports are safe for all patients.”
The registry was funded by the ICD manufacturers Boston Scientific, Medtronic and St. Jude Medical.
As published originally in Forbes