Vigorous athletic activity is safe with implanted arrhythmia devices

There has long been concern that people with implantable cardioverter-defibrillators (ICDs) should not participate in any kind of strenuous sports activity for fear that their devices could fail. But a new Yale study finds that many athletes with ICDs can engage in vigorous and competitive sports without physical injury or failure to stop cardiac arrhythmia, despite ICD shocks that may occur to the heart during athletic activities.

The study appears in Circulation, a journal of the American Heart Association.

ICDs are small devices that deliver a jolt of electricity to the hearts of patients when it detects an irregular heartbeat, or arrhythmia. The Yale researchers studied 372 athletes with ICDs between the ages of 10 and 60 who were participating in organized or high-risk sports. Running, basketball, and soccer were the most common sports. Over a follow-up period lasting between 21 and 46 months, there were no occurrences of death, resuscitated arrest, arrhythmia, or shock-related injury during sports participation. When athletes did experience shocks during competitions, practice, or at rest — even for potentially life-threatening heart rhythms — the ICD terminated all episodes and restored normal heartbeat.

“This study will provide a basis for more informed physician and patient decision-making for athletes with ICDs who wish to participate in strenuous sports activities,” said lead author Dr. Rachel Lampert, associate professor of medicine at Yale School of Medicine.

The study was supported by grants from Boston Scientific, Medtronic, and St. Jude Medical.

Other authors are Cheryl Barth; Dr. Cynthia Brandt, James Dziura, and Fangyong Li of Yale; Dr. Brian Olshansky and Dr. Ian Law of the University of Iowa; Dr. Hein Heidbuchel of University Hospitals Leuven, Belgium; Dr. Christine Lawless of Sports Cardiology Consultants LLC; Dr. Elizabeth Saarel of the University of Utah; Dr. Michael Ackerman of the Mayo Clinic; Dr. Hugh Calkins and Dr. Alan Cheng of Johns Hopkins University; Dr. N.A. Mark Estes and Dr. Mark S. Link of Tufts Medical Center; Dr. Barry J. Maron of the Minneapolis Heart Institute; Dr. Frank Marcus of the University of Arizona; Dr. Melvin Scheinman of the University of California San Francisco;
 Dr. Bruce L. Wilkoff of the Cleveland Clinic Foundation; Dr. Douglas P. Zipes of Indiana University; Dr. Charles I. Berul of Children’s National Medical Center; Michele Loomis, APRN, of Michigan Heart; and Dr. David Cannom of The Hospital of the Good Samaritan and Cedar Sinai Heart Institute.

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