Arrhythmogenic Cardiomyopathy and Athletes: A Dangerous Relationship

Arrhythmogenic cardiomyopathy (ACM) is a disease characterized by a progressive replacement of myocardium by fibro-adipose material, predispos-ing to ventricular arrhythmias (VA) and sudden car-diac death (SCD). Its prevalence is estimated at 1:2000 to 1:5000, with a higher incidence in males, and clini-cal onset is usually between the 2nd and 4th decade of life. The prevalence of ACM in SCD victims is rela-tively high, making it one of the most common etiolo-gies in young patients with SCD, especially if they are athletes. Cardiac events occur more frequently in indi-viduals with ACM who participate in competitive sports and/or high-intensity training. In effect, exercise activity can worsen RV function in cases of hereditary ACM. Estimating the incidence of SCD caused by ACM in athletes remains challenging, being reported frequency ranging from 3% to 20%. Here, we review the potential implications of exercising on the clinical course of the classical genetic form of ACM, as well as the diagnostic tools, risk stratification, and the differ-ent therapeutic tools available for managing ACM. (Curr Probl Cardiol 2023;48:101799.)

Automated summary

Arrhythmogenic cardiomyopathy (ACM) is a disease characterized by progressive replacement of myocardium by fibro-adipose material, leading to ventricular arrhythmias and sudden cardiac death. It is more common in males and usually onset in the 2nd to 4th decade of life. ACM is one of the most common causes of sudden cardiac death in young patients, especially athletes. Exercise can worsen right ventricular function in hereditary ACM.