Lifestyle physical activity and rapid-rate non-sustained ventricular tachycardia in arrhythmogenic cardiomyopathy

Objective To investigate the association of accelerometer-measured lifestyle physical activity with rapid-rate non-sustained ventricular tachycardias (RR-NSVTs) in patients with arrhythmogenic cardiomyopathy (AC). Methods This multicentre, observational study enrolled 72 patients with AC, including right, left and biventricular forms of the disease, with underlying desmosomal and non-desmosomal mutations. Lifestyle physical activity, objectively monitored with accelerometers (ie, movement sensors) and RR-NSVT, identified as >188 bpm and >18 beats from a textile Holter ECG for 30 days. Results Sixty-three patients with AC (38±17.6 years, 57% men) were included. A total of 17 patients experienced ≥1 RR-NSVTs, and a total of 35 events were recorded. The odds of occurrence of ≥1 RR-NSVT during the recording did not increase as a function of either total physical activity (OR 0.95, 95% CI (CI95%) 0.68 to 1.30 for 60 min increase) or moderate-to-vigorous activities (OR 0.89, CI95% 0.71 to 1.08 for 5 min increase). Participants presenting RR-NSVTs during the recording (n=17) did not present greater odds of RR-NSVT in the days with more time either in total physical activity (OR 1.05, CI95% 0.84 to 1.29 for additional 60 min) or moderate-to-vigorous activities (OR 1.05, CI95% 0.97 to 1.12 for additional 5 min). Physical activity levels were neither different between the patients with and without RR-NSVTs during the recording period nor in the days of occurrence of RR-NSVT compared with the rest of the days. Finally, 4 of the 35 RR-NSVTs recorded in the 30 days occurred during physical activity (3 during moderate-to-vigorous intensity and 1 during light-intensity activities). Conclusions These findings suggest that lifestyle physical activity is not associated with RR-NSVTs in patients with AC.

[1]  J. Migueles,et al.  Device-measured physical activity, sedentary time, and sleep in patients with arrhythmogenic cardiomyopathy: descriptive values and stability over 30 measurement days , 2022, medRxiv.

[2]  Stefan L. Zimmerman,et al.  A new prediction model for ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy , 2022, European heart journal.

[3]  H. Lamb,et al.  Nonsustained Ventricular Tachycardia Is Independently Associated With Sustained Ventricular Arrhythmias in Nonischemic Dilated Cardiomyopathy. , 2022, Circulation. Arrhythmia and electrophysiology.

[4]  A. Braza-Boïls,et al.  Facts and Gaps in Exercise Influence on Arrhythmogenic Cardiomyopathy: New Insights From a Meta-Analysis Approach , 2021, Frontiers in Cardiovascular Medicine.

[5]  G. T. Gunnarsson,et al.  2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. , 2020, European heart journal.

[6]  A. Mazzanti,et al.  Diagnosis of arrhythmogenic cardiomyopathy: The Padua criteria. , 2020, International journal of cardiology.

[7]  Alex V. Rowlands,et al.  GGIR: A Research Community–Driven Open Source R Package for Generating Physical Activity and Sleep Outcomes From Multi-Day Raw Accelerometer Data , 2019, Journal for the Measurement of Physical Behaviour.

[8]  P. Lambiase,et al.  Definition and treatment of arrhythmogenic cardiomyopathy: an updated expert panel report , 2019, European journal of heart failure.

[9]  Stefan L. Zimmerman,et al.  Retracted and Republished: A new prediction model for ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy , 2019, European heart journal.

[10]  Thor Edvardsen,et al.  Prediction of Life-Threatening Ventricular Arrhythmia in Patients With Arrhythmogenic Cardiomyopathy: A Primary Prevention Cohort Study. , 2018, JACC. Cardiovascular imaging.

[11]  L. Morcillo-Hidalgo,et al.  Impact of dynamic physical exercise on high‐risk definite arrhythmogenic right ventricular cardiomyopathy , 2018, Journal of cardiovascular electrophysiology.

[12]  Jorgen A Wullems,et al.  Reliability and validity of the international physical activity questionnaire compared to calibrated accelerometer cut-off points in the quantification of sedentary behaviour and physical activity in older adults , 2018, PloS one.

[13]  M. Bucan,et al.  Estimating sleep parameters using an accelerometer without sleep diary , 2018, bioRxiv.

[14]  U. Ekelund,et al.  Evaluation of raw acceleration sedentary thresholds in children and adults , 2017, Scandinavian journal of medicine & science in sports.

[15]  H. Calkins,et al.  Safety of American Heart Association-recommended minimum exercise for desmosomal mutation carriers. , 2016, Heart rhythm.

[16]  M. Link,et al.  Association of competitive and recreational sport participation with cardiac events in patients with arrhythmogenic right ventricular cardiomyopathy: results from the North American multidisciplinary study of arrhythmogenic right ventricular cardiomyopathy. , 2015, European heart journal.

[17]  H. Calkins,et al.  Sports in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy and desmosomal mutations , 2015, Herz.

[18]  T. Edvardsen,et al.  Vigorous physical activity impairs myocardial function in patients with arrhythmogenic right ventricular cardiomyopathy and in mutation positive family members , 2014, European journal of heart failure.

[19]  Ulf Ekelund,et al.  Age group comparability of raw accelerometer output from wrist- and hip-worn monitors. , 2014, Medicine and science in sports and exercise.

[20]  Ulf Ekelund,et al.  Guide to the assessment of physical activity: Clinical and research applications: a scientific statement from the American Heart Association. , 2013, Circulation.

[21]  S. Russell,et al.  Exercise increases age-related penetrance and arrhythmic risk in arrhythmogenic right ventricular dysplasia/cardiomyopathy-associated desmosomal mutation carriers. , 2013, Journal of the American College of Cardiology.

[22]  Roy J. Shephard,et al.  2011 Compendium of Physical Activities: A Second Update of Codes and MET Values , 2012 .

[23]  Duncan J Macfarlane,et al.  Validity of the international physical activity questionnaire short form (IPAQ-SF): A systematic review , 2011, The international journal of behavioral nutrition and physical activity.

[24]  M. Link,et al.  Prophylactic Implantable Defibrillator in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia and No Prior Ventricular Fibrillation or Sustained Ventricular Tachycardia , 2010, Circulation.

[25]  G. Breithardt,et al.  Age- and Training-Dependent Development of Arrhythmogenic Right Ventricular Cardiomyopathy in Heterozygous Plakoglobin-Deficient Mice , 2006, Circulation.

[26]  S. Russell,et al.  Predictors of appropriate implantable defibrillator therapies in patients with arrhythmogenic right ventricular dysplasia. , 2005, Heart rhythm.

[27]  Maurizio Schiavon,et al.  Does sports activity enhance the risk of sudden death in adolescents and young adults? , 2003, Journal of the American College of Cardiology.