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  
Introduction: 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. Results: 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). Conclusion: 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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