title: Use of implantable cardioverter-defibrillators in athletes: A systematic review.
abstract: International guidelines exclude athletes with implantable cardioverter-defibrillators (ICDs) from participating in sports, except those of low intensity (category IA, such as golf, billiards or bowling). However, these guidelines are based on expert consensus, and thus the safety and risks of participating in sports in this population are still largely unknown in the medical community. We performed a systematic review of the literature in PubMed using the following search string: "((sudden cardiac death) AND (sport OR physical exercise)) AND defibrillator". After the application of pre-defined inclusion and exclusion criteria, 36 results were selected, which are explored in this paper. Preliminary results on ICD use in this population appear to demonstrate the safety and efficacy of the device in this context. Further studies, with longer follow-up and with larger samples, may provide stronger evidence to support these findings. In the meantime, disqualifying almost all ICD patients from participating in sports, without taking into consideration their individual needs and characteristics, may be prejudicial to a considerable number of patients by preventing them from exercising their profession or engaging in recreational sport, for which their risk of sudden cardiac death may be low.
authors.affiliation: Universidade de Coimbra, Faculdade de Medicina, Coimbra, Portugal.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Liz Almeida
authors.affiliation: Universidade de Coimbra, Faculdade de Medicina, Coimbra, Portugal; Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. Electronic address: rui_providencia@yahoo.com.
authors.forename: Rui
authors.initials: R
authors.lastname: Providência
authors.affiliation: Universidade de Coimbra, Faculdade de Medicina, Coimbra, Portugal; Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Lino
authors.initials: L
authors.lastname: Gonçalves
mesh_terms: D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D017147:Defibrillators, Implantable; D006801:Humans; D013177:Sports
keywords: Arrhythmia; Arritmia; Athlete; Atletas; Cardioversor desfibrilhador implantável; Desporto; Desqualificação; Disqualification; Implantable cardioverter defibrillator; Morte súbita cardíaca; Sports; Sudden cardiac death