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Sports_ICD_Overview.html
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<!DOCTYPE html>
<html lang="en">
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<head>
<meta charset="UTF-8">
<title>CardioRef: AHA/ACC 2015 Sports Participation Selector Guide: Athlete with ICD</title>
<link rel="stylesheet" href="css/sports_answer_combined.css">
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<div class="topbar">
<a href="index.html">Pedi CardioRef</a>
<div class="guidelinebar">
<a target="_blank" rel="noopener noreferrer" href="https://www.ahajournals.org/doi/10.1161/CIR.0000000000000245">
Reference: ACC/AHA Sports Participation Recommendations (Circulation 2015) Task Force 9</a>
</div>
</div>
<section style="margin:10px">
<p class="topspace"></p>
<label><b>By the ACC/AHA 2015 guidelines, should my patient with</label>
<select name="disease" id="dz" class="InputBox" onChange="goThere();">
<option value="">*Select Disease*</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="HCM">Hypertrophic Cardiomyopathy </option>
<option value="LVNC">Left Ventricular Non-Compaction </option>
<option value="DilRestr">Dilated or Restrictive Cardiomyopathy </option>
<option value="ARVC">Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) </option>
<option value="Myo">Myocarditis </option>
<option value="Peri">Pericarditis </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="ASDVSDPDA">ASD, VSD, or PDA </option>
<option value="PS">Pulmonic Stenosis </option>
<option value="AS">Aortic Stenosis </option>
<option value="Coarct">Coarctation </option>
<option value="Cyan">Cyanotic Heart Disease, unrepaired or with palliative shunt </option>
<option value="TOF">Tetralogy of Fallot, s/p repair </option>
<option value="TGA_Must">d-transposition (d-TGA), s/p atrial switch (Mustard/Senning)</option>
<option value="TGA_Art">d-transposition (d-TGA), s/p arterial switch </option>
<option value="CCTGA">Congenitally-corrected TGA (CC-TGA, L-TGA)</option>
<option value="Fontan">Fontan </option>
<option value="Ebstein">Ebstein Anomaly </option>
<option value="AnomCoronary">Anomalous Coronary Artery Origin</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="PVR">Pulmonary hypertension in CHD </option>
<option value="VentricularDysfxn">Ventricular Dysfunction s/p CHD Surgery</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="Valve_AS">Aortic Stenosis</option>
<option value="Valve_AR">Aortic Regurgitation </option>
<option value="Valve_MS">Mitral Stenosis</option>
<option value="Valve_MR">Mitral Regurgitation </option>
<option value="Valve_Hx">History of Mitral or Aortic Valve Surgery</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="HTN">Hypertension </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="Marfan">Aortic Diseases, Including Marfan Syndrome</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="CoronaryOverview">Coronary Artery Disease </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="Syncope">Syncope </option>
<option value="Arrhythmia">Arrhythmias (SVT, PVC, Vtach, etc.) </option>
<option value="ConductionDefect">Conduction Defects (AV block, brady, pacemaker, RBBB/LBBB)</option>
<option value="Channelopathies">Channelopathies (LQTS, CPVT, Brugada, etc.) </option>
<option value="ICD">Implantable Cardioverter-Defibrillator (ICD) </option>
</select>
<span>participate in organized sports?</span></b>
<br><br>
<section id="question">
Should my patient with <b>an ICD</b> participate in organized sports?
</section>
</section>
<br>
<section class="single_center">
<p class="sectiontitle">Overarching recommendations:</p>
<p>"ICD indications for competitive athletes should <u>not</u> differ from those applicable to the general population
with appropriate diagnoses and clinical profiles."</p>
<p class="rec_class">(Class I Recommendation; Level of Evidence C)</p>
<p>"Recommendations should be based on existing evidence for benefit and risk and should include discussions of potential impact on
sport-specific participation and performance."</p>
<p class="rec_class">(Class I Recommendation; Level of Evidence C)</p>
<p>"The desire of the athlete to continue athletic competition should <u>not</u> represent the primary indication
for use of an ICD."</p>
<p class="rec_class">(Class III Recommendation; Level of Evidence C)</p>
</section>
<p></p>
<section id="answer">
<section class ="half_left_invisible">
<p class="sectiontitle" align=center>Class IIa (reasonable) recommendation:</p>
</section>
<section class ="half_right_invisible">
<p class="sectiontitle" align=center>Class IIb (may be considered) recommendation:</p>
</section>
</section>
<section class="half_left">
<p>"Participation in sports classified as IA for athletes with an ICD is reasonable
if they are free of episodes of ventricular flutter or ventricular fibrillation
requiring device therapy for 3 months."
</p>
<div class="verdict_ok"><b>Class IA sports are reasonable, if free of vflutter/vfib for 3 months</b></div>
<p class="rec_class">(Class IIa Recommendation; Level of Evidence C)</p>
</section>
<section class="half_right">
<p>
"Participation in sports with higher peak static and dynamic components than
class IA may be considered if the athlete is free of episodes of ventricular flutter
or ventricular fibrillation requiring device therapy for 3 months. </p><p>
The decision regarding athletic participation should be made with consideration of,
and counseling of, the athlete regarding the higher likelihood of appropriate and inappropriate shocks
and the potential for device-related trauma in high-impact sports."
</p>
<div class="verdict_maybe"><b>May consider sports other than IA if conditions met and counseled of risks</b></div>
<p class="rec_class">(Class IIb Recommendation; Level of Evidence C)</p>
</section>
</section>
<p class="foot">
<br>
<b>Reference:</b> <a href="https://www.ahajournals.org/doi/10.1161/CIR.0000000000000245"><i>Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities. Task Force 9.
A Scientific Statement From the AHA and ACC.</i></a> <i>Circulation 2015</i>
<br><br><b>Disclaimer:</b> This website is derived from published guidelines, but does not constitute medical advice nor does it replace clinical judgement. Only the text in quotation marks are direct quotations from the original guidelines. Text not in quotations as well as the method of information display are all that of the website creator and are not part of the original published guidelines. Please consult a physician to discuss any patient-specific matters.
</p>
<section class="key">
<p><b>Key:</b>vflutter = ventricular flutter, vfib = ventricular fibrillation
</p>
</section>
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