Safety of sports for athletes with implantable cardioverter-defibrillators: Results of a prospective, multinational registry

Rachel Lampert, Brian Olshansky, Hein Heidbuchel, Christine Lawless, Elizabeth Saarel, Michael Ackerman, Hugh Calkins, N. A.Mark Estes, Mark S. Link, Barry J. Maron, Frank Marcus, Melvin Scheinman, Bruce L. Wilkoff, Douglas P. Zipes, Charles I. Berul, Alan Cheng, Ian Law, Michele Loomis, Cheryl Barth, Cynthia BrandtJames Dziura, Fangyong Li, David Cannom

Research output: Contribution to journalArticle

116 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)2021-2030
Number of pages10
JournalCirculation
Volume127
Issue number20
DOIs
StatePublished - May 21 2013

Fingerprint

Implantable Defibrillators
Athletes
Sports
Registries
Shock
Safety
Cardiac Arrhythmias
Exercise
Basketball
Athletic Injuries
Soccer
International Classification of Diseases
Running
Medical Records
Decision Making
Interviews
Physicians
Equipment and Supplies
Wounds and Injuries
Population

Keywords

  • defibrillators
  • implantable
  • sports

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Lampert, R., Olshansky, B., Heidbuchel, H., Lawless, C., Saarel, E., Ackerman, M., ... Cannom, D. (2013). Safety of sports for athletes with implantable cardioverter-defibrillators: Results of a prospective, multinational registry. Circulation, 127(20), 2021-2030. https://doi.org/10.1161/CIRCULATIONAHA.112.000447

Safety of sports for athletes with implantable cardioverter-defibrillators : Results of a prospective, multinational registry. / Lampert, Rachel; Olshansky, Brian; Heidbuchel, Hein; Lawless, Christine; Saarel, Elizabeth; Ackerman, Michael; Calkins, Hugh; Estes, N. A.Mark; Link, Mark S.; Maron, Barry J.; Marcus, Frank; Scheinman, Melvin; Wilkoff, Bruce L.; Zipes, Douglas P.; Berul, Charles I.; Cheng, Alan; Law, Ian; Loomis, Michele; Barth, Cheryl; Brandt, Cynthia; Dziura, James; Li, Fangyong; Cannom, David.

In: Circulation, Vol. 127, No. 20, 21.05.2013, p. 2021-2030.

Research output: Contribution to journalArticle

Lampert, R, Olshansky, B, Heidbuchel, H, Lawless, C, Saarel, E, Ackerman, M, Calkins, H, Estes, NAM, Link, MS, Maron, BJ, Marcus, F, Scheinman, M, Wilkoff, BL, Zipes, DP, Berul, CI, Cheng, A, Law, I, Loomis, M, Barth, C, Brandt, C, Dziura, J, Li, F & Cannom, D 2013, 'Safety of sports for athletes with implantable cardioverter-defibrillators: Results of a prospective, multinational registry', Circulation, vol. 127, no. 20, pp. 2021-2030. https://doi.org/10.1161/CIRCULATIONAHA.112.000447
Lampert, Rachel ; Olshansky, Brian ; Heidbuchel, Hein ; Lawless, Christine ; Saarel, Elizabeth ; Ackerman, Michael ; Calkins, Hugh ; Estes, N. A.Mark ; Link, Mark S. ; Maron, Barry J. ; Marcus, Frank ; Scheinman, Melvin ; Wilkoff, Bruce L. ; Zipes, Douglas P. ; Berul, Charles I. ; Cheng, Alan ; Law, Ian ; Loomis, Michele ; Barth, Cheryl ; Brandt, Cynthia ; Dziura, James ; Li, Fangyong ; Cannom, David. / Safety of sports for athletes with implantable cardioverter-defibrillators : Results of a prospective, multinational registry. In: Circulation. 2013 ; Vol. 127, No. 20. pp. 2021-2030.
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AU - Lampert, Rachel

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AU - Lawless, Christine

AU - Saarel, Elizabeth

AU - Ackerman, Michael

AU - Calkins, Hugh

AU - Estes, N. A.Mark

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AU - Marcus, Frank

AU - Scheinman, Melvin

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AU - Cheng, Alan

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N2 - 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.

AB - 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.

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