Influence of Exercise and Sport Activity on Functional Symptoms and Ventricular Arrhythmias in Arrhythmogenic Right Ventricular Disease.

C. Daubert, M. Vauthier, F. Carre, M. Laurent, C. Leclercq, P. Mabo. Department of Cardiology, University Hospital, Rennes, FRANCE. J Am Coll Cardiol 1994;23:34A

Sport Activity (SA), the circumstances in which functional symptoms (FS) occurred, and the influence of exercise testing (ET) on ventricular arrhythmias (VA) were analyzed in 74 consecutive pts, 51 males and 23 females, referred to the same institution between 1981 and 1992 for arrhythmogenic right ventricular disease (ARVD). Mean age at symptom onset was 35±12.5 years.

22 pts (29.7%) had intensive and regular SA (sport group), including competition in 13 (17.6%) (cycling:8; running:3; soccer:1; triathlon:1). Compared to nonsport group, mean age was significantly lower (28.3±10.2 vs 36.5±13.3 yrs; p<0.02). FS (palpitations:75%; presyncope:52%; syncope:30%; aborted sudden death:2.7%) were obviously related to exercise in 31 pts (42%), exclusively in 25 and preferentially in 6. This feature was significantly more frequent in sport group (14/22 vs 17/52: p<0.01). Considering all pts, there was no significant difference for age between pts with exercise related FS and others. VA were significantly worsened during ET in 33 pts (46.6%), including exercise induced sustained VT in 13 and non sustained VT in 9. VA exercise worsening was more frequent in sport group (15/22=68.2%) than in non sport group (18/52=34.8%; p<0.01).

In conclusion, this study shows a surprising but obvious association between ARVD and SA. In addition, the high prevalence of exercise related FS and of exercise induced VA indicates that the consequences of ARVD are very dependent on sympathetic tone, especially in athletes. This can suggest an important role for beta-blockers to treat those pts.