Athlete with a Device: Implantable Cardioverter Defibrillators and Pacemakers

  • Rachel Lampert
  • J. Philip Saul


WK is a former collegiate varsity basketball player at Pepperdine University who at age 19 had a frank syncopal spell while running during practice. Cardiologic evaluation demonstrated unequivocal hypertrophic cardiomyopathy (HCM) and an internal cardioverter defibrillator (ICD) was implanted. There was no family history of sudden cardiac death (SCD).


Ventricular Arrhythmia Sudden Cardiac Death Implantable Cardioverter Defibrillator Sport Participation Competitive Sport 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Maron BJ, Zipes DP: 36th Bethesda Conference: Eligibility recommendations for competitive athletes with cardiovascular abnormalities. J Am Coll Cardiol 2005; 45:1313–1375.CrossRefGoogle Scholar
  2. 2.
    Lampert R, Cannom D: Sports participation for athletes with implantable cardioverter-defibrillators should be an individualized risk-benefit decision. Heart Rhythm 2008; 5:861–863.PubMedCrossRefGoogle Scholar
  3. 3.
    Rardon JR: Burt ends UW career. 2006, Seattle Times, 1/6/06.Google Scholar
  4. 4.
    Bevilacqua L, Hordof A: Cardiac pacing in children. Curr Opin Cardiol 1998; 13:48–55.PubMedCrossRefGoogle Scholar
  5. 5.
    Maron BJ, Zipes D: It is not prudent to allow all athletes with implantable cardioverter-defibrillators to participate in all sports. Heart Rhythm 2008; 5:864–866.PubMedCrossRefGoogle Scholar
  6. 6.
    Schron EB, Exner DV, Yao Q, et al.: Quality of life in the antiarrhythmics versus implantable defibrillators. Circulation 2002; 105:589–594.PubMedCrossRefGoogle Scholar
  7. 7.
    McAllister DR, Motamedi AR, Hame SL, et al.: Quality of life assessment in elite collegiate athletes. Am J Sports Med 2001; 29:806–810.PubMedGoogle Scholar
  8. 8.
    Albert CM, Mittleman MA, Chae CU, et al.: Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med 2000; 343:1355–1361.PubMedCrossRefGoogle Scholar
  9. 9.
    Corrado D, Basso C, Rizzoli G, et al.: Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol 2003; 42:1959–1963.PubMedCrossRefGoogle Scholar
  10. 10.
    Maron BJ, Shirani J, Poliac L, et al.: Sudden death in young competitive athletes: Clinical, demographic, and pathological profiles. JAMA 1996; 276:199–204.PubMedCrossRefGoogle Scholar
  11. 11.
    Estes INAM, Link MS, Cannom D, et al.: Report of the NASPE policy conference on arrhythmias and the athlete. J Cardiovasc Electrophysiol 2001; 12:1208–1219.PubMedCrossRefGoogle Scholar
  12. 12.
    Lampert R, Joska T, Burg MM, et al.: Emotional and physical precipitants of ventricular arrhythmia. Circulation 2002; 106:1800–1805.PubMedCrossRefGoogle Scholar
  13. 13.
    Medbo JI, Sejersted OM: Plasma potassium changes with high intensity exercise. J Physiol 1990; 421:105–122.PubMedGoogle Scholar
  14. 14.
    Sims JJ, Miller AW, Ujhelyi MR: Regional hyperkalemia increases ventricular defibrillation energy requirements: Role of electrical heterogeneity in defibrillation. [see comment]. J Cardiovasc Electrophysiol 2000; 11:634–641.PubMedCrossRefGoogle Scholar
  15. 15.
    Osnes JB, Hermansen L: Acid-base balance after maximal exercise of short duration. J Appl Physiol 1972; 32:59–63.PubMedGoogle Scholar
  16. 16.
    Kjaer M: Epinephrine and some other hormonal responses to exercise in man: With special reference to physical training. Int J Sports Med 1989; 10:2–15.PubMedCrossRefGoogle Scholar
  17. 17.
    Sousa J, Kou W, Calkins H, et al.: Effect of epinephrine on the efficacy of the internal cardioverter-defibrillator. Am J Cardiol 1992; 69:509–512.PubMedCrossRefGoogle Scholar
  18. 18.
    Suddath WO, Deychak Y, Varghese PJ: Electrophysiologic basis by which epinephrine facilitates defibrillation after prolonged episodes of ventricular fibrillation. Ann Emerg Med 2001; 38:201–206.PubMedCrossRefGoogle Scholar
  19. 19.
    Venditti FJ, John RM, Hull ML, et al.: Circadian variation in defibrillation energy requirements. Circulation 1996; 94:1607–1612.PubMedCrossRefGoogle Scholar
  20. 20.
    Turton MB, Deegan T: Circadian variations of plasma catecholamine, cortisol, and immunoreactive insulin concentrations in supine subjects. Clin Chim Acta 1974; 55:389–397.PubMedCrossRefGoogle Scholar
  21. 21.
    Lampert R, Jain D, Burg MM, et al.: Destabilizing effects of mental stress on ventricular arrhythmias in patients with implantable cardioverter-defibrillators. Circulation 2000; 101:158–164.PubMedCrossRefGoogle Scholar
  22. 22.
    Qin H, Walcott GP, Killingsworth CR, et al.: Impact of myocardial ischemia and reperfusion on ventricular defibrillation patterns, energy requirements, and detection of recovery. Circulation 2002; 105:2537–2542.PubMedCrossRefGoogle Scholar
  23. 23.
    Pires LA, Lehmann MH, Steinman RT, et al.: Sudden death in implantable cardioverter-defibrillator recipients: Clinical context, arrhythmic events and device responses. J Am Coll Cardiol 1998; 33:24–32.CrossRefGoogle Scholar
  24. 24.
    Pires LA, Hull ML, Nino CL, et al.: Sudden death in recipients of transvenous implantable cardioverter defibrillator systems: Terminal events, predictors, and potential mechanisms. J Cardiovasc Electrophysiol 1999; 10:1049–1056.PubMedCrossRefGoogle Scholar
  25. 25.
    Mitchell LB, Pineda EA, Titus JL, et al.: Sudden death in patients with implantable cardioverter-defibrillators: The importance of post-shock electromechanical dissociation. J Am Coll Cardiol 2002; 39:1323–1328.PubMedCrossRefGoogle Scholar
  26. 26.
    Maron BJ, Shen WK, Link MS, et al.: Efficacy of implantable cardioverter-defibrillators for the prevention of sudden death in patients with hypertrophic cardiomyopathy. N Eng J Med 2000; 342:365–373.CrossRefGoogle Scholar
  27. 27.
    Begley DA, Mohiddin SA, Tripodi D, et al.: Efficacy of implantable cardioverter-defibrillator therapy for primary and secondary prevention of sudden cardiac death in hypertrophic cardiomyopathy. PACE 2003; 26:1887–1896.PubMedCrossRefGoogle Scholar
  28. 28.
    Corrado D, Leoni L, Link MS, et al.: Implantable cardioverter-defibrillator therapy for prevention of sudden death in patients with arrhythmogenic right ventricular dysplasia. Circulation 2003; 108:3084–3091.PubMedCrossRefGoogle Scholar
  29. 29.
    Zareba W, Moss AJ, Daubert JP, et al.: Implantable cardioverter-defibrillator in high-risk long QT syndrome patients. J Cardiovasc Electrophysiol 2003; 14:337–341.PubMedCrossRefGoogle Scholar
  30. 30.
    Papaioannou GI, Klugar J: Ineffective ICD therapy due to excessive alcohol and exercise. PACE 2002; 25:1144–1145.PubMedCrossRefGoogle Scholar
  31. 31.
    Akiyama T, Powell JL, Mitchell LB, et al.: Resumption of driving after life-threatening ventricular tachyarrhythmia. N Eng J Med 2001; 345:391–397.CrossRefGoogle Scholar
  32. 32.
    Lawless CE: Safety and efficacy of implantable cardioverter-defibrillators and automatic external defibrillators in athletes. Clin J Sport Med 15(5):386–391.Google Scholar
  33. 33.
    Lampert R, Cannom D, Olshansky B: Safety of sports participation in patients with implantable cardioverter-defibrillators: A survey of Heart Rhythm Society Members. J Cardiovasc Electrophysiol 2006; 17:11–15.PubMedCrossRefGoogle Scholar
  34. 34.
    Gajewski KK, Reed JH, Pilcher TA, et al.: Activity recommendations in paced pediatric patients: Wide variations among practitioners. Heart Rhythm 2008; 5:S95.Google Scholar
  35. 35.
    Kron J, Herre J, Renfroe EG, et al.: Lead- and device-related complications in the Antiarrhythmics versus Implantable Defibrillators Trial. Am Heart J 2001; 141:92–98.PubMedCrossRefGoogle Scholar
  36. 36.
    Zipes DP, Roberts D, Pacemaker-Cardioverter-Defibrillator Investigators: Results of the International Study of the Implantable Pacemaker Cardioverter-Defibrillator. Circulation 1995; 92:59–65.PubMedCrossRefGoogle Scholar
  37. 37.
    Luria D, Glikson M, Brady PA, et al.: Predictors and mode of detection of transvenous lead malfunction in implantable defibrillators. Am J Cardiol 2001; 87:901–904.PubMedCrossRefGoogle Scholar
  38. 38.
    Fortescue EB, Berul CI, Cecchin F, et al.: Patient, procedural, and hardware factors associated with pacemaker lead failures in pediatrics and congenital heart disease. Heart Rhythm 2004; 1:150–159.PubMedCrossRefGoogle Scholar
  39. 39.
    Hossack KF, Hartwig R: Cardiac arrest associated with supervised cardiac rehabilitation. J Cardiac Rehab 1982; 2:402–408.Google Scholar
  40. 40.
    Hauer K, Niebauer J, Weiss C, et al.: Myocardial ischemia during physical exercise in patients with stable coronary disease: Predictability and prevention. Int J Cardiol 2000; 75:179–186.PubMedCrossRefGoogle Scholar
  41. 41.
    Maron BJ, Chaitman BR, Ackerman MJ, et al.: Recommendations for physical activity and recreational sports participation for young patients with genetic cardiovascular diseases. Circulation 2004; 109:2807–2816.PubMedCrossRefGoogle Scholar
  42. 42.
    Epstein AE, Miles WM, Benditt DG, et al.: Personal and public safety issues related to arrhythmias that may affect consciousness: AHA/NASPE Medical/scientific statement. Circulation 1996; 94:1147–1166.PubMedCrossRefGoogle Scholar
  43. 43.
    Paffenbarger RS, Hyde RT, Wing AL, et al.: Physical activity, all-cause mortality, and longevity of college alumni. N Eng J Med 1986; 314:605–613.CrossRefGoogle Scholar
  44. 44.
    Wannamethee SG, Shaper AG, Walker M: Physical activity and mortality in older men with diagnosed coronary heart disease. Circulation 2000; 102:1358–1363.PubMedCrossRefGoogle Scholar
  45. 45.
    Tanasescu M, Leitzmann MF, Rimm EB, et al.: Exercise type and intensity in relation to coronary heart disease in men. JAMA 2002; 288:1994–2000.PubMedCrossRefGoogle Scholar
  46. 46.
    Lemaitre RN, Siscovick DS, Raghunathan TE, et al.: Leisure-time physical activities and the risk of primary cardiac arrest. Arch Intern Med 1999; 159:686–690.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Section of CardiologyYale University School of MedicineNew HavenUSA

Personalised recommendations