Athletic Activity Aggravates Frequency of Ventricular Arrhythmias in Arrhythmogenic Right Ventricular Cardiomyopathy Patients
Heart Rhythm Scientific Sessions 2013
Jørg Saberniak, MD; Nina E. Hasselberg, MD; Rasmus Borgquist, MD, PhD; Pyotr G. Platonov, MD, PhD; Anders G. Holst, MD, PhD; Thor Edvardsen, MD, PhD; and Kristina H. Haugaa, MD, PhD
Case reports have indicated that high level of physical activity increase risk of ventricular arrhythmias (VAs) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). However, a systematic study of frequency of VAs in athletes with ARVC has not previously been performed.
Methods: In total, 112 consecutive ARVC probands and mutation-positive family members from the Nordic ARVC registry were studied (42 ±17 years, 58% male). Participants with history of estimated activity level > 750 metabolic equivalents (METs)-min/week or > 4 hours vigorous activity a week were defined as athletes. Exercise induced VAs were defined as ventricular tachycardias and aborted cardiac arrests during exercise.
The definition of athlete’s status was fulfilled in 37(33%), while 75 (67%) were non-athletes. Athletes were younger at time of diagnosis than non-athletes (36±13 vs. 45±18 years, p<0.01) (Figure). Exercise induced VAs occurred in 40 patients (36%) and were more frequent in athletes (27/37, 73%) compared to non-athletes (13/75, 17%) (p<0.001). The number of probands was higher among athletes (27/37, 73%) than among non-athletes (37/75, 49%, p=0.02). Among probands (n=64), all athletes (100%) had exercise induced VAs compared to only 31% of non athletes (p<0.001).
These findings confirm that exercise induced VAs are frequent in patients with ARVC and even more frequent in ARVC patients with athletic activity compared to ARVC non-athletes. Furthermore, athletes were younger and more frequently probands, indicating that athletic activity may aggravate the onset of life threatening symptoms in ARVC.
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