Competitive Sports Participation in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia: A Single Center's Early Experience

Stuart A. Ostby, J. Martijn Bos, Heidi J. Owen, Philip L. Wackel, Bryan C. Cannon, Michael John Ackerman

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objectives The study sought to determine the outcomes of continued sports participation in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT). Background Patients with CPVT are at increased risk of sudden death with exertion. Currently, CPVT patients are advised disqualification from nearly all sports in accordance with expert opinion guidelines. However, we have approached this complex issue with a shared decision making model respecting a patient's and their family's right to be a competitive athlete following institution of comprehensive CPVT-directed treatment program. Methods A retrospective record review was performed on patients with CPVT who were >6 years of age at the time of initial evaluation to determine their athlete status and frequency/scope of subsequent CPVT-triggered events. Results Among 63 eligible patients with CPVT (34 females, mean age at diagnosis 16.6 ± 12.9 years), 31 (49%) were athletes at some point in their life. Compared to the nonathletes, these athletes were significantly younger at diagnosis (11.8 ± 6.6 years vs. 21.3 ± 15.6 years; p = 0.003) and more symptomatic (21 [68%] vs. 13 [41%]; p = 0.04). Following diagnosis, 21 of 24 athletes (88%) continued competition. For these 21 athletes, 16 (76%) had experienced 32 CPVT-triggered events prior to diagnosis versus 57 events in 18 nonathletes (43%; p = 0.02). During follow-up, 3 events occurred in 3 of 21 athletes (14%) compared to 7 events in 6 of 42 nonathletes (14%, p = 1.00). No event resulted in death, and all received an adjustment in their CPVT therapy. Conclusions Although sports participation is a risk taking behavior in undiagnosed and untreated CPVT, the risk may be acceptable for a well-treated and well-informed athlete following the diagnosis of CPVT.

Original languageEnglish (US)
Pages (from-to)253-262
Number of pages10
JournalJACC: Clinical Electrophysiology
Volume2
Issue number3
DOIs
StatePublished - 2016

Fingerprint

Sports
Inpatients
Athletes
Risk-Taking
Polymorphic catecholergic ventricular tachycardia
Patient Participation
Social Adjustment
Expert Testimony
Sudden Death
Decision Making
Guidelines
Therapeutics

Keywords

  • athletes
  • catecholeminergic polymorphic ventricular tachycardia
  • CPVT
  • LCSD
  • left cardiac sympathetic denervation
  • sports
  • sudden death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Competitive Sports Participation in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia : A Single Center's Early Experience. / Ostby, Stuart A.; Bos, J. Martijn; Owen, Heidi J.; Wackel, Philip L.; Cannon, Bryan C.; Ackerman, Michael John.

In: JACC: Clinical Electrophysiology, Vol. 2, No. 3, 2016, p. 253-262.

Research output: Contribution to journalArticle

Ostby, Stuart A. ; Bos, J. Martijn ; Owen, Heidi J. ; Wackel, Philip L. ; Cannon, Bryan C. ; Ackerman, Michael John. / Competitive Sports Participation in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia : A Single Center's Early Experience. In: JACC: Clinical Electrophysiology. 2016 ; Vol. 2, No. 3. pp. 253-262.
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abstract = "Objectives The study sought to determine the outcomes of continued sports participation in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT). Background Patients with CPVT are at increased risk of sudden death with exertion. Currently, CPVT patients are advised disqualification from nearly all sports in accordance with expert opinion guidelines. However, we have approached this complex issue with a shared decision making model respecting a patient's and their family's right to be a competitive athlete following institution of comprehensive CPVT-directed treatment program. Methods A retrospective record review was performed on patients with CPVT who were >6 years of age at the time of initial evaluation to determine their athlete status and frequency/scope of subsequent CPVT-triggered events. Results Among 63 eligible patients with CPVT (34 females, mean age at diagnosis 16.6 ± 12.9 years), 31 (49{\%}) were athletes at some point in their life. Compared to the nonathletes, these athletes were significantly younger at diagnosis (11.8 ± 6.6 years vs. 21.3 ± 15.6 years; p = 0.003) and more symptomatic (21 [68{\%}] vs. 13 [41{\%}]; p = 0.04). Following diagnosis, 21 of 24 athletes (88{\%}) continued competition. For these 21 athletes, 16 (76{\%}) had experienced 32 CPVT-triggered events prior to diagnosis versus 57 events in 18 nonathletes (43{\%}; p = 0.02). During follow-up, 3 events occurred in 3 of 21 athletes (14{\%}) compared to 7 events in 6 of 42 nonathletes (14{\%}, p = 1.00). No event resulted in death, and all received an adjustment in their CPVT therapy. Conclusions Although sports participation is a risk taking behavior in undiagnosed and untreated CPVT, the risk may be acceptable for a well-treated and well-informed athlete following the diagnosis of CPVT.",
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AB - Objectives The study sought to determine the outcomes of continued sports participation in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT). Background Patients with CPVT are at increased risk of sudden death with exertion. Currently, CPVT patients are advised disqualification from nearly all sports in accordance with expert opinion guidelines. However, we have approached this complex issue with a shared decision making model respecting a patient's and their family's right to be a competitive athlete following institution of comprehensive CPVT-directed treatment program. Methods A retrospective record review was performed on patients with CPVT who were >6 years of age at the time of initial evaluation to determine their athlete status and frequency/scope of subsequent CPVT-triggered events. Results Among 63 eligible patients with CPVT (34 females, mean age at diagnosis 16.6 ± 12.9 years), 31 (49%) were athletes at some point in their life. Compared to the nonathletes, these athletes were significantly younger at diagnosis (11.8 ± 6.6 years vs. 21.3 ± 15.6 years; p = 0.003) and more symptomatic (21 [68%] vs. 13 [41%]; p = 0.04). Following diagnosis, 21 of 24 athletes (88%) continued competition. For these 21 athletes, 16 (76%) had experienced 32 CPVT-triggered events prior to diagnosis versus 57 events in 18 nonathletes (43%; p = 0.02). During follow-up, 3 events occurred in 3 of 21 athletes (14%) compared to 7 events in 6 of 42 nonathletes (14%, p = 1.00). No event resulted in death, and all received an adjustment in their CPVT therapy. Conclusions Although sports participation is a risk taking behavior in undiagnosed and untreated CPVT, the risk may be acceptable for a well-treated and well-informed athlete following the diagnosis of CPVT.

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