New recommendations green-light some athletes with heart disease to compete

November 02, 2015

DALLAS, Texas, Nov. 2, 2015 -- For the first time, joint recommendations may permit participation in competitive sports for some athletes diagnosed with a specific type of irregular heartbeat and for others who have an implanted medical device that regulates the heart's rhythm.

The joint American Heart Association/American College of Cardiology scientific statement published in both the American Heart Association's journal Circulation and the Journal of the American College of Cardiology.

The new recommendations apply only to athletes with diagnosed heart disease who participate in competitive level sports directed by a coach (i.e. football, basketball, baseball and others). They do not apply to those who occasionally participate in sports for fun or exercise.

Previous recommendations noted that the risk of sudden cardiac arrest during competitive sports was too high for many athletes with Long QT syndrome, a condition that can result in delayed electrical recovery of the heartbeat, causing fast, chaotic heartbeats that can be life threatening. New medical research indicates, however, that the risk of sudden cardiac arrest is lower than previously thought for these patients.

Similarly, the new research shows a lower risk of sudden cardiac arrest among some competitive athletes with some types of heartbeat disorders treated by an implanted medical device. These devices include pacemakers, which regulate a slow heartbeat, and ICDs, (implantable cardioverter defibrillators), which shock the heart during fast heartbeats to restore a normal rhythm. Under the new recommendations, some of these athletes now may be able to compete -- with their healthcare provider's approval, since every patient is different.

"These recommendations are intended to help healthcare providers and competitive athletes make individualized decisions based on the most current scientific research, the patient's understanding of their risk and the healthcare provider's clinical judgment, but are not intended to establish absolute mandates or to make the general medical (and legal) standard of care applicable to all competitive athletes," said Barry Maron, M.D., co-chair of the writing committee and director of the Hypertrophic Cardiomyopathy Center at the Minneapolis Heart Institute Foundation.

"It should be noted that the guidance for patients with hypertrophic cardiomyopathy has not changed -- we still recommend avoiding intense competitive sports for people who have this condition," Maron said.

Patients with hypertrophic cardiomyopathy have abnormally thick heart muscles, which can cause life-threatening irregular heartbeats, especially with intense physical activity.

When an apparently healthy athlete unexpectedly collapses and dies during an intense sports practice or competition, the cause often is sudden cardiac arrest. Unlike a heart attack, which results from blocked blood flow to the heart, sudden cardiac arrest occurs when the heart malfunctions and beats abnormally, often due to an underlying congenital, genetic or acquired cardiac condition.

"The ultimate incentive is to prevent sudden cardiac death in the young, although it is also important not to unfairly or unnecessarily remove individuals from a healthy athletic lifestyle," said Douglas P. Zipes, M.D., co-chair of the statement writing group and distinguished professor at Indiana University School of Medicine, Krannert Institute of Cardiology in Indianapolis, Indiana.

The scientific statement also provides recommendations for evaluating other congenital, genetic and acquired cardiac conditions that could increase the risk of sudden cardiac arrest among competitive athletes, as well as emphasizing the importance of avoiding performance-enhancing drugs which also increase risk. The statement notes it is also critical for competitive athletes and their coaches to learn how to use an emergency medical device, or AED (automated external defibrillator), which can restore a normal heartbeat in a person who has experienced a cardiac arrest.

"The panel recognizes and strongly supports the well-documented health benefits of exercise, with regular physical activities encouraged for those individuals who have been removed from organized competitive athletics," Zipes said.

To calculate the risk of sudden cardiac arrest, an expert panel at the American Heart Association and the American College of Cardiology analyzed detailed medical reports on competitive athletes with different types of heart disease. In addition to irregular heartbeat, these diseases include heart-valve damage, high blood pressure, and narrowing of the blood vessels, among many others. Some of these diseases are present at birth, while others develop later in life.

The organizations have not changed their screening recommendations, and continue to recommend that healthcare professionals use a checklist of 14 key elements for screening young people, including athletes, age 12-25, for congenital and genetic heart disease.

If any of the elements are positive, further testing may be needed, but initial screening using electrocardiograms (ECGs) to detect underlying genetic and congenital heart disease in this age group prior to the checklist has not been shown to save lives and is not recommended by either the American Heart Association or the American College of Cardiology.
Co-authors and disclosures are listed on the individual manuscripts that comprise the scientific statement.

Additional Resources:

AHA and ACC logos and heart illustration are located in the right column of the release link
Citations and Weblinks (pdf)
Congenital Heart Defects
Follow AHA/ASA news on Twitter @HeartNews.

The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association's science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical companies and device manufacturers, is available at

American Heart Association

Related Heart Disease Articles from Brightsurf:

Cellular pathway of genetic heart disease similar to neurodegenerative disease
Research on a genetic heart disease has uncovered a new and unexpected mechanism for heart failure.

Mechanism linking gum disease to heart disease, other inflammatory conditions discovered
The link between periodontal (gum) disease and other inflammatory conditions such as heart disease and diabetes has long been established, but the mechanism behind that association has, until now, remained a mystery.

New 'atlas' of human heart cells first step toward precision treatments for heart disease
Scientists have for the first time documented all of the different cell types and genes expressed in the healthy human heart, in research published in the journal Nature.

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.

Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.

Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.

Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.

New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.

Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.

Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.

Read More: Heart Disease News and Heart Disease Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to