Implantable cardioverter defibrillators in athletes: rationale for use and issues surrounding return to play.

摘要

Although the 36~th Bethesda Guidelines for sports participation recommend that athletes with implanted cardioverter-defibrillators (ICDs) be disqualified from participating in sports (1), surveys of implanting physicians and sports medicine specialists indicate that the majority of athletes with ICDs are participating in some form of sports activity (2,3).ICDs are implanted to treat episodes of sudden cardiac arrest (SCA) caused by ventricular fibrillation (VF) in high-risk individuals. Such individuals are identified either by having experienced a prior VF episode from which they were resuscitated (secondary prevention patient) or by having an underlying high-risk cardiac condition known to pre-dispose to VF (primary prevention patient). The epidemiology of SCA differs significantly in the athletic population compared with the general population, but the indications for ICD implant are the same in all patient groups (4).