Safety of Sports for Young Patients With Implantable Cardioverter-Defibrillators

Elizabeth Vickers Saarel, Ian Law, Charles I. Berul, Michael John Ackerman, Ronald J. Kanter, Shubhayan Sanatani, Mitchell I. Cohen, Stuart Berger, Peter S. Fischbach, David A. Burton, James Dziura, Cynthia Brandt, Laura Simone, Fangyong Li, Brian Olshansky, David S. Cannom, Rachel J. Lampert

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

BACKGROUND: Despite safety concerns, many young patients with implantable cardioverter-defibrillators (ICDs) participate in sports. We undertook a prospective, multinational registry to determine the incidence of serious adverse events because of sports participation. The primary end points were death or resuscitated arrest during sports or injury during sports because of arrhythmia or shock. Secondary end points included system malfunction and incidence of ventricular arrhythmias requiring multiple shocks for termination. METHODS: Athletes with ICDs aged ≤21 years were included in this post hoc subanalysis of the ICD Sports Registry. Data on sports and clinical outcomes were obtained by phone interview and medical records review. ICD shocks and clinical details of lead malfunction were classified by 2 electrophysiologists. RESULTS: A total of 129 young athletes participating in competitive (n=117) or dangerous (n=12) sports were enrolled. The mean age was 16 years (range, 10-21; 40% female; 92% white). The most common diagnoses were long QT syndrome (n=49), hypertrophic cardiomyopathy (n=30), and congenital heart disease (n=16). The most common sports were basketball and soccer, including 79 varsity/junior varsity high school and college athletes. During a median follow-up of 42 months, 35 athletes (27%) received 38 shocks. There were no occurrences of death, arrest, or injury related to arrhythmia, during sports. There was 1 ventricular tachycardia/ventricular fibrillation storm during competition. Freedom from lead malfunction was 92.3% at 5 years and 79.6% at 10 years. CONCLUSIONS: Although shocks related to competition/practice are not uncommon, there were no serious adverse sequelae. Lead malfunction rates were similar to previously reported in unselected pediatric ICD populations. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov . Unique identifier: NCT00637754.

Original languageEnglish (US)
Pages (from-to)e006305
JournalCirculation. Arrhythmia and electrophysiology
Volume11
Issue number11
DOIs
StatePublished - Nov 1 2018

Fingerprint

Implantable Defibrillators
Sports
Safety
Shock
Athletes
Cardiac Arrhythmias
Registries
Basketball
Long QT Syndrome
Athletic Injuries
Soccer
Hypertrophic Cardiomyopathy
Incidence
Ventricular Fibrillation
Ventricular Tachycardia
Medical Records
Heart Diseases
Clinical Trials
Interviews
Pediatrics

Keywords

  • arrhythmias, cardiac
  • death, sudden, cardiac
  • defibrillators, implantable
  • shock
  • sports

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Safety of Sports for Young Patients With Implantable Cardioverter-Defibrillators. / Saarel, Elizabeth Vickers; Law, Ian; Berul, Charles I.; Ackerman, Michael John; Kanter, Ronald J.; Sanatani, Shubhayan; Cohen, Mitchell I.; Berger, Stuart; Fischbach, Peter S.; Burton, David A.; Dziura, James; Brandt, Cynthia; Simone, Laura; Li, Fangyong; Olshansky, Brian; Cannom, David S.; Lampert, Rachel J.

In: Circulation. Arrhythmia and electrophysiology, Vol. 11, No. 11, 01.11.2018, p. e006305.

Research output: Contribution to journalArticle

Saarel, EV, Law, I, Berul, CI, Ackerman, MJ, Kanter, RJ, Sanatani, S, Cohen, MI, Berger, S, Fischbach, PS, Burton, DA, Dziura, J, Brandt, C, Simone, L, Li, F, Olshansky, B, Cannom, DS & Lampert, RJ 2018, 'Safety of Sports for Young Patients With Implantable Cardioverter-Defibrillators', Circulation. Arrhythmia and electrophysiology, vol. 11, no. 11, pp. e006305. https://doi.org/10.1161/CIRCEP.118.006305
Saarel, Elizabeth Vickers ; Law, Ian ; Berul, Charles I. ; Ackerman, Michael John ; Kanter, Ronald J. ; Sanatani, Shubhayan ; Cohen, Mitchell I. ; Berger, Stuart ; Fischbach, Peter S. ; Burton, David A. ; Dziura, James ; Brandt, Cynthia ; Simone, Laura ; Li, Fangyong ; Olshansky, Brian ; Cannom, David S. ; Lampert, Rachel J. / Safety of Sports for Young Patients With Implantable Cardioverter-Defibrillators. In: Circulation. Arrhythmia and electrophysiology. 2018 ; Vol. 11, No. 11. pp. e006305.
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abstract = "BACKGROUND: Despite safety concerns, many young patients with implantable cardioverter-defibrillators (ICDs) participate in sports. We undertook a prospective, multinational registry to determine the incidence of serious adverse events because of sports participation. The primary end points were death or resuscitated arrest during sports or injury during sports because of arrhythmia or shock. Secondary end points included system malfunction and incidence of ventricular arrhythmias requiring multiple shocks for termination. METHODS: Athletes with ICDs aged ≤21 years were included in this post hoc subanalysis of the ICD Sports Registry. Data on sports and clinical outcomes were obtained by phone interview and medical records review. ICD shocks and clinical details of lead malfunction were classified by 2 electrophysiologists. RESULTS: A total of 129 young athletes participating in competitive (n=117) or dangerous (n=12) sports were enrolled. The mean age was 16 years (range, 10-21; 40{\%} female; 92{\%} white). The most common diagnoses were long QT syndrome (n=49), hypertrophic cardiomyopathy (n=30), and congenital heart disease (n=16). The most common sports were basketball and soccer, including 79 varsity/junior varsity high school and college athletes. During a median follow-up of 42 months, 35 athletes (27{\%}) received 38 shocks. There were no occurrences of death, arrest, or injury related to arrhythmia, during sports. There was 1 ventricular tachycardia/ventricular fibrillation storm during competition. Freedom from lead malfunction was 92.3{\%} at 5 years and 79.6{\%} at 10 years. CONCLUSIONS: Although shocks related to competition/practice are not uncommon, there were no serious adverse sequelae. Lead malfunction rates were similar to previously reported in unselected pediatric ICD populations. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov . Unique identifier: NCT00637754.",
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AU - Sanatani, Shubhayan

AU - Cohen, Mitchell I.

AU - Berger, Stuart

AU - Fischbach, Peter S.

AU - Burton, David A.

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N2 - BACKGROUND: Despite safety concerns, many young patients with implantable cardioverter-defibrillators (ICDs) participate in sports. We undertook a prospective, multinational registry to determine the incidence of serious adverse events because of sports participation. The primary end points were death or resuscitated arrest during sports or injury during sports because of arrhythmia or shock. Secondary end points included system malfunction and incidence of ventricular arrhythmias requiring multiple shocks for termination. METHODS: Athletes with ICDs aged ≤21 years were included in this post hoc subanalysis of the ICD Sports Registry. Data on sports and clinical outcomes were obtained by phone interview and medical records review. ICD shocks and clinical details of lead malfunction were classified by 2 electrophysiologists. RESULTS: A total of 129 young athletes participating in competitive (n=117) or dangerous (n=12) sports were enrolled. The mean age was 16 years (range, 10-21; 40% female; 92% white). The most common diagnoses were long QT syndrome (n=49), hypertrophic cardiomyopathy (n=30), and congenital heart disease (n=16). The most common sports were basketball and soccer, including 79 varsity/junior varsity high school and college athletes. During a median follow-up of 42 months, 35 athletes (27%) received 38 shocks. There were no occurrences of death, arrest, or injury related to arrhythmia, during sports. There was 1 ventricular tachycardia/ventricular fibrillation storm during competition. Freedom from lead malfunction was 92.3% at 5 years and 79.6% at 10 years. CONCLUSIONS: Although shocks related to competition/practice are not uncommon, there were no serious adverse sequelae. Lead malfunction rates were similar to previously reported in unselected pediatric ICD populations. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov . Unique identifier: NCT00637754.

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