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Safety of Sports for Athletes With Implantable Cardioverter-Defibrillators: Results of a Prospective, Multinational Registry
Journal article   Open access   Peer reviewed

Safety of Sports for Athletes With Implantable Cardioverter-Defibrillators: Results of a Prospective, Multinational Registry

Rachel LAMPERT, Brian OLSHANSKY, Frank MARCUS, Melvin SCHEINMAN, Bruce L WILKOFF, Douglas P ZIPES, Charles I BERUL, Alan CHENG, Ian LAW, Michele LOOMIS, …
Circulation (New York, N.Y.), Vol.127(20), pp.2021-2030
2013
DOI: 10.1161/CIRCULATIONAHA.112.000447
PMID: 23690453
url
https://doi.org/10.1161/CIRCULATIONAHA.112.000447View
Published (Version of record) Open Access

Abstract

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.
 Cardiology. Vascular system Biological and medical sciences Medical sciences Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Blood and lymphatic vessels Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)

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