The Lead Episode 30: A Discussion of Return-to-Play for Elite Athletes With Genetic Heart Diseases Predisposing to Sudden Cardiac Death-Journal of the American College of Cardiology

Journal of the American College of Cardiology

Pdf Summary

A study published in the Journal of the American College of Cardiology has found that elite athletes with genetic heart diseases (GHDs) predisposing to sudden cardiac death (SCD) can safely return to competitive sports after a comprehensive clinical evaluation and shared decision making (SDM) process. The study included 76 elite athletes, the majority of whom were diagnosed with hypertrophic cardiomyopathy (53%) or long QT syndrome (26%). Most athletes were initially disqualified from their sport following their GHD diagnosis, but after careful evaluation and SDM, 72% of athletes opted for unrestricted return-to-play (RTP). The study followed the athletes for an average of 7 years with no exercise-related deaths and only 1 exercise-related and 2 non-exercise-related adverse cardiac events occurring. The study suggests that with proper risk stratification and tailored therapy, RTP following SDM is associated with low rates of adverse cardiac events in elite athletes with GHDs. It highlights the need for a shift from a historical paradigm of immediate disqualification to a more patient-centered approach in managing athletes with GHDs, taking into account their individual risks and preferences. The study recommends further research to fully define the risks and benefits of RTP for athletes with GHDs.

Keywords

elite athletes

genetic heart diseases

sudden cardiac death

clinical evaluation

shared decision making

hypertrophic cardiomyopathy

long QT syndrome

return-to-play

adverse cardiac events

risk stratification