CARDIAC-ARREST AND SUDDEN-DEATH IN COMPETITIVE ATHLETES WITH ARRHYTHMOGENIC RIGHT-VENTRICULAR DYSPLASIA

Arrhythmogenic right ventricular dysplasia (ARVD) is a predisposing fa ctor for sport-related cardiac arrest (CA), sudden cardiac death (SD). and life-threatening ventricular tachyarrhythmias (VT). The aim of th is study was the assessment of athletes with ARVD, particularly the CA survivors. From 1974 to January 1996, 1642 competitive athletes (aver . 25.5 yr.), 136 of whom were top level athletes (TLA), were studied f or important arrhythmic manifestations. All athletes underwent an indi vidualised study protocol including a series of non invasive and invas ive diagnostic techniques. One hundred and one athletes (90 males, 11 females, aver. 25.9 yr.) were diagnosed as being affected by ARVD on t he basis of the WHO/ISFC criteria. The same percentage (about 6%) of A RVD is present in both the general arrhythmic athletes population and in the subgroup of TLA. Prevalence of ARVD among athletes with CA or S D is high (respectively 23% and 25%), confirming the observation that ARVD is one of the major causes of SD in Italian athletes All CA were athletic activity related, indicating the potentiality of of exercise as a cause of electrical destabilisation in subjects with ARVD. In ath letes with documented ARVD intense sport activity has to be proscribed . In athletes at risk of CA or SD an aggressive treatment, ICD implant ation and RF catheter ablation must be taken into consideration.