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Abstract
Important advances in the diagnosis and therapy of various arrhythmic disorders have been made in the last two decades. These, in turn, have necessitated a re-examination of current practice guidelines, with a view to deciding on optimal management of young patients with suspected or proven arrhythmia syndromes and in assessing the risk of adverse arrhythmic events during sport participation. There has also been a concomitant emphasis on identifying individuals at risk by nationwide screening programs using the ECG and excluding them from competitive sport. This review identifies some of these issues, looks at the data critically and offers some suggestions for current care and future research.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Should patients with asymptomatic Wolff–Parkinson–White syndrome undergo ‘prophylactic’ catheter ablation routinely? This has been addressed in the first section of this review.
What is the role of routine preparticipation screening of young persons wishing to participate in organized sporting activities? The review argues against this approach as being ineffective on several grounds.
Should patients with LQTS be allowed to participate in sporting activities at higher levels beyond the currently (and not universally) accepted level? Limited data suggest that this is the case; further follow-up data and prospective studies will clarify this issue further and result in a relaxation and update of current guidelines.
How should we advise the young patient with an ICD who wishes to participate in recreational or competitive sport? Data are limited but appear to suggest that the current guidelines may be relaxed.