title: 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.
  
  
  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.
authors.affiliation: Yale University School of Medicine, 789 Howard Ave, Dana 319, New Haven, CT 06511, USA. rachel.lampert@yale.edu
authors.forename: Rachel
authors.initials: R
authors.lastname: Lampert
authors.forename: Brian
authors.initials: B
authors.lastname: Olshansky
authors.forename: Hein
authors.initials: H
authors.lastname: Heidbuchel
authors.forename: Christine
authors.initials: C
authors.lastname: Lawless
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Saarel
authors.forename: Michael
authors.initials: M
authors.lastname: Ackerman
authors.forename: Hugh
authors.initials: H
authors.lastname: Calkins
authors.forename: N A Mark
authors.initials: NA
authors.lastname: Estes
authors.forename: Mark S
authors.initials: MS
authors.lastname: Link
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Maron
authors.forename: Frank
authors.initials: F
authors.lastname: Marcus
authors.forename: Melvin
authors.initials: M
authors.lastname: Scheinman
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Wilkoff
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Zipes
authors.forename: Charles I
authors.initials: CI
authors.lastname: Berul
authors.forename: Alan
authors.initials: A
authors.lastname: Cheng
authors.forename: Ian
authors.initials: I
authors.lastname: Law
authors.forename: Michele
authors.initials: M
authors.lastname: Loomis
authors.forename: Cheryl
authors.initials: C
authors.lastname: Barth
authors.forename: Cynthia
authors.initials: C
authors.lastname: Brandt
authors.forename: James
authors.initials: J
authors.lastname: Dziura
authors.forename: Fangyong
authors.initials: F
authors.lastname: Li
authors.forename: David
authors.initials: D
authors.lastname: Cannom
mesh_terms: D000293:Adolescent; D000328:Adult; D056352:Athletes; D001265:Athletic Injuries / Q000453:epidemiology* / Q000517:prevention & control; D002648:Child; D017147:Defibrillators, Implantable / Q000009:adverse effects / Q000592:standards*; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013177:Sports / Q000592:standards*; D055815:Young Adult
keywords: defibrillators, implantable; sports