A new scientific statement from the American Heart Association, published today in the journal Circulation, indicates that physical activity in children and teenagers with cardiomyopathy or implantable cardioverter-defibrillators (ICDs) may be safer than previous research suggested. The statement emphasizes a shift from blanket restrictions to personalized, monitored participation, highlighting the importance of physical activity for childhood development and long-term health.
While safety remains paramount, halting all physical activity among children with these conditions has led to unintended consequences, including negative impacts on heart health, physical fitness, mental well-being, social development, and quality of life, according to Jonathan B. Edelson, M.D., M.S.C.E., chair of the writing group. The statement provides a framework for clinicians, families, and patients to engage in shared decision-making, balancing risks and benefits based on individual diagnosis, risk profile, and personal goals.
Key recommendations include tailored risk assessments using diagnostic tools such as echocardiograms, cardiac imaging, exercise stress tests, and genetic testing. Close follow-up and reassessment are critical as children grow and their conditions evolve. The statement outlines that light-to-moderate intensity exercise, such as walking, light cycling, or swimming, may be appropriate for maintaining fitness and social development. For some carefully selected patients, participation in competitive sports may be reasonable after expert assessment. Emergency action plans, including access to automated external defibrillators (AEDs) and bystanders trained in CPR, are essential during organized sports.
The statement acknowledges that most evidence comes from observational studies in adults, so findings should be applied cautiously to pediatric populations. More research is needed on how exercise affects disease progression and risk across different cardiomyopathies. The American Heart Association's scientific statements are intended to inform health care decisions and highlight areas needing further study, but they do not replace official clinical practice guidelines.
Co-authors include Jennifer Conway, Carissa Baker-Smith, Barbara Cifra, Melissa Cousino, Sharlene Day, Jonathan A. Drezner, Anne M. Dubin, Corey Gates, and David White. The Association receives funding from various sources, including individuals and corporations, with strict policies to prevent influence on scientific content. For more information, visit the American Heart Association's website or the Circulation journal page.
