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Safety of Sports for Athletes With Implantable Cardioverter-Defibrillators: Results of a Prospective, Multinational Registry
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.
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“Ventricular arrhythmias requiring multiple shocks occurred in 8 episodes in 7 patients, 2% of the study population, all of whom had either catecholaminergic polymorphic ventricular tachycardia, idiopathic ventricular fibrillation, or coronary artery disease.”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [106]
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“Over a median two and half years follow-up, shocks, both appropriate and inappropriate, were not rare.”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [106]
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“Freedom from lead malfunction was 97% at 5 years (from implant) and 90% at 10 years, similar to previously-reported malfunction rates in unselected populations.66”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [106]
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“Shocks occurred at similar rates during competition or practice, occurring in 10% of participants, as during other physical activity, occurring in 8%, although were statistically less common at rest, occurring in 6%.”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [106]
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“However, there were no occurrences of either primary endpoint: 1) death or resuscitated arrest, or 2) arrhythmia-or shock-related injury, during sports.”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [106]
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Self-citation
Metadata
- Authors
- Lampert, R., Olshansky, B., Heidbuchel, H., Lawless, C., Saarel, E., Ackerman, M., Calkins, H., Estes, N. A. M., Link, M. S., Maron, B. J., Marcus, F., Scheinman, M., Wilkoff, B. L., Zipes, D. P., Berul, C. I., Cheng, A., Law, I., Loomis, M., Barth, C., Brandt, C., Dziura, J., Li, F., & Cannom, D.
- Affiliations
- University of Iowa (US)
- From the Yale University School of Medicine, New Haven, CT (R.L., C.B., C.B., J.D., F.L.); University of Iowa, Iowa City (B.O., I.L.); University Hospitals Leuven, Leuven, Belgium (H.H.); Sports Cardiology Consultants LLC, Chicago, IL (C.L.); University of Utah, Salt Lake City (E.S.); Mayo Clinic, Rochester, MN (M.A.); Johns Hopkins, Baltimore, MD (H.C., A.C.); Tufts Medical Center, Boston, MA (N.A.M.E., M.S.L.); Minneapolis Heart Institute, Minneapolis, MN (B.J.M.); University of Arizona, Tucson (F...
- ORCID
- Venue
- Circulation
- Published
- 2013-05-21
- Volume
- 127
- Issue
- 20
- Pages
- 2021-2030
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W1996214292
- Semantic Scholar
- 89cd7d2d8332a805d9f2a873b6aa0aa2cca6e9c3
- Cited by
- 286
- References
- 45
- Citations by year
- 2026: 15 · 2025: 14 · 2024: 21 · 2023: 14 · 2022: 13 · 2021: 39 · 2020: 26 · 2019: 13 · 2018: 28 · 2017: 30 · 2016: 26 · 2015: 24 · 2014: 14 · 2013: 5
- FWCI
- 15.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- AstraZeneca
- Sanofi
- University of Rochester
- Boston Scientific Corporation
- Georgia Clinical and Translational Science Alliance (UL1 RR024139)
- Bayer HealthCare
- European Society of Cardiology
- National Institutes of Health
- St. Jude Medical
- Medical Center, University of Rochester
- National Center for Research Resources (CTSA Grant Number UL1 RR024139, RR024139, UL1RR024139)
- National Center for Advancing Translational Sciences (CTSA Grant Number UL1 RR024139, RR024139)
- Biosense Webster
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- implantable cardioverter-defibrillator, athletes, sports participation, ICD shocks, inappropriate shocks, ventricular arrhythmias, lead malfunction, sudden cardiac death, physical activity safety
- MeSH terms
- Adolescent, Adult, Athletic Injuries, Child, Female, Humans, Male, Middle Aged, Prospective Studies, Registries, Risk Factors, Sports, Defibrillators, Implantable, Internationality, Young Adult, Athletes
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