2024 HRS expert consensus statement on arrhythmias in the athlete: Evaluation, treatment, and return to play
Open accessAbstract
Youth and adult participation in sports continues to increase, and athletes may be diagnosed with potentially arrhythmogenic cardiac conditions. This international multidisciplinary document is intended to guide electrophysiologists, sports cardiologists, and associated health care team members in the diagnosis, treatment, and management of arrhythmic conditions in the athlete with the goal of facilitating return to sport and avoiding the harm caused by restriction. Expert, disease-specific risk assessment in the context of athlete symptoms and diagnoses is emphasized throughout the document. After appropriate risk assessment, management of arrhythmias geared toward return to play when possible is addressed. Other topics include shared decision-making and emergency action planning. The goal of this document is to provide evidence-based recommendations impacting all areas in the care of athletes with arrhythmic conditions. Areas in need of further study are also discussed.
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There is a strong association between AF and genes KCNA5, SCN5A, and TTN, while LMNA and KCNQ1 present a weaker association with AF.
“There is a strong association between AF and genes such as KCNA5, SCN5A and TTN, while genes like LMNA and KCNQ1 present a weaker association with AF [35,36,37,38].”
From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [38]
Recent guidelines reflect a trend toward considering catheter ablation as a first-line option in symptomatic patients with AF, irrespective of athletic status, particularly in patients who do not respond well to medical management or prefer a non-pharmacological approach.
“Recent guidelines reflect this trend toward considering catheter ablation as a first-line option in symptomatic patients with AF, irrespective of athletic status, thus acknowledging the benefits of early ablation for symptomatic AF, particularly in patients who do not respond well to medical management or who prefer a non-pharmacological approach [38].”
From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [38]
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“Smart devices which have the ability to record athletes’ rhythms, such as wearable smartwatches, other commercially available wearable devices, or handheld ECG recording devices, may be useful in recording the athlete’s heart rhythm during the time they are symptomatic [38].”
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- Authors
- Lampert, R., Chung, E. H., Ackerman, M. J., Arroyo, A. R., Darden, D., Deo, R., Dolan, J., Etheridge, S. P., Gray, B. R., Harmon, K. G., James, C. A., Kim, J. H., Krahn, A. D., La Gerche, A., Link, M. S., MacIntyre, C., Mont, L., Salerno, J. C., & Shah, M. J.
- Affiliations
- Yale University (US)
- Harvard University (US)
- Mayo Clinic (US)
- Kansas City Heart Rhythm Institute (US)
- University of Pennsylvania (US)
- University of Utah (US)
- The University of Sydney (AU)
- University of Washington (US)
- Johns Hopkins University (US)
- Emory University (US)
- University of British Columbia (CA)
- The University of Texas Southwestern Medical Center (US)
- Children's Hospital of Philadelphia (US)
- ORCID
- Venue
- Heart Rhythm
- Publisher
- Elsevier BV
- Published
- 2024-10
- Volume
- 21
- Issue
- 10
- Pages
- e151-e252
- ISSN
- 1547-5271 (ISSN-L)
- OpenAlex
- W4397024284
- Cited by
- 167
- References
- 711
- Citations by year
- 2026: 83 · 2025: 66 · 2024: 18
- FWCI
- 50.39
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Heart Rhythm (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- athlete's heart, arrhythmogenic cardiomyopathy, sudden cardiac death in athletes, risk assessment, return to sport, shared decision-making, emergency action planning, sports cardiology, arrhythmia management
- MeSH terms
- Return to Sport, Arrhythmias, Cardiac, Humans, Sports Medicine, Death, Sudden, Cardiac, Risk Assessment, Consensus, Athletes
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