Recommendations for athletes returning to sports with implantable cardiac defibrillators

Sudden cardiac arrests represent a significant cause of disease in young people, with athletes being at higher risk. For athletes who have previously had cardiac arrest, an implantable cardiac defibrillator (ICD) is the primary avenue to prevent a subsequent cardiac event.

Yale researchers have now published a review in the journal Cardiac Electrophysiology Clinics summarizing existing studies on how athletes can return to engaging in sports activity after cardiac arrest with ICDs.

The largest study to address this, the ICD Sports Registry, found no sports-related deaths, injuries, or cardiac arrests in athletes returning to sports with an ICD, including athletes participating in high-intensity sports. Additionally, that study found ICDs can be set to a higher threshold for providing a shock to athletes, without an increase in negative outcomes.

These studies have led to changing perspectives on athletes with ICDs and their ability to engage in their original activities, moving towards shared decision-making between the athlete and their medical team rather than previous recommendations of sports restrictions for athletes with an ICD.

The most recent recommendations for athletes with ICDs can be found in a consensus statement published in Heart Rhythm guiding decisions on sports participation for athletes with arrhythmic cardiac conditions and for athletes with ICDs, as well as other conditions.

The statement provides evidence-based recommendations on all areas of care to help guide the diagnosis, treatment, and management of arrhythmic conditions in athletes to support a return to sports. Rachel Lampert, MD, Robert W. Berliner Professor of Medicine (cardiovascular medicine), is the first author of this statement.