• Interventional Techniques & Devices Clinical Trials

Data from an implantable cardioverter defibrillator (ICD) sports registry do not support a blanket restriction of athletes who have ICDs from participating in all moderate- and high-intensity competitive sports, according to Rachel Lampert, MD, Yale School of Medicine, New Haven, Connecticut, USA. Dr. Lampert presented results from a prospective analysis of a multinational registry.

The aim of the research was to identify and follow athletes with ICDs who participate in competitive or dangerous sports to quantify associated risks. The primary endpoints were death or failure to convert an arrhythmia, resulting in the need for external resuscitation during or after sports participation, and injury that results from arrhythmia or shock during sports.

The study population consisted of 372 self-selected athletes between the ages of 10 and 60 years from 41 North American and 18 European sites. Most participants (97%) were men, 94% were white, and the majority (59%) had an ICD indication of secondary prevention.

Data were collected by interview and medical records. Participants were contacted every 6 months and instructed to call investigators after they received a shock. Medical records and ICD stored data were obtained for shocks that were received or changes in medical status.

Investigators found no tachyarrhythmic death or externally resuscitated tachyarrthymia during or after sports. They also found no injuries that were sustained from arrhythmia or shock during sports. Thirty-seven participants received ICD shocks during sports, 4 stopped sports completely, and 7 stopped 1 or some sports. Five participants stopped at least 1 sport because of shocks that were received at other times.

At 1 year, 315 athletes had shocks, with a 95% CI of 1% to 1.2%, and at 2 years, 243 athletes had shocks, with a 95% CI of 0% to 1.5%. Since the number of athletes that were studied is small, the upper bounds of the 95% CIs (1.2% and 1.5%) are meaningful.

In total, the number of shocks for competitive sports was higher than those for other physical activities or noise/other (Figure 1). The investigators concluded that shocks were not rare during sports. No serious health consequences occurred, and most participants returned to sports despite shocks. “Whether or not patients with ICDs return to sports should be an individual decision,” Dr. Lampert said.

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Figure 1.

Shocks Received.

Reproduced with permission from R. Lampert, MD.

• © 2012 MD Conference Express