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Return to play in the athlete with cardiac disease: who decides and what is the protocol?

Published online by Cambridge University Press:  13 January 2017

Michael J. Silka
Michael J. Silka*
Affiliation:
Division of Cardiology, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
*
Correspondence to: M. J. Silka, MD, Division of Cardiology, Children’s Hospital Los Angeles, 4650 Sunset Blvd; MS #34, Los Angeles, CA 90027, United States of America. Tel: 323 361 2405; Fax: 323-361-1513; E-mail: msilka@chla.usc.edu
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Abstract

Improved public awareness and advances in medical diagnostics have resulted in the development of criteria to determine eligibility or disqualification for the athlete with cardiovascular abnormalities. Simultaneously, protocols have been developed for athletes with concussion or orthopaedic injuries to guide team physicians and consultants in return-to-play decisions. However, there are currently inadequate data to allow the development of such protocols for athletes with cardiovascular abnormalities who have undergone treatment. Further complicating the decision process is the designation of the team physician as the ultimate authority in making return-to-play decisions – where the team physician often is an employee of the team and supports the team’s goal and players as well as the individual athlete. This review will discuss the ethical dilemma of the team physician and the role of the cardiovascular consultant. Following this, current data and practices regarding return to play will be discussed for the following conditions or diagnoses: following catheter ablation for supraventricular tachycardia; following pacemaker or implantable cardioverter-defibrillator implantation; unexplained syncope; and the athlete with a genetic mutation in the absence of any phenotype of associated disease. These recommendations will undoubtedly continue to evolve and improve and should be considered at this time as a point of departure.

Keywords

Return to playsudden cardiac deathathletic competitionsports competition
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Supplement S1: Sudden Cardiac Arrest in the Young: A Contemporary Perspective , January 2017 , pp. S110 - S114
Copyright
© Cambridge University Press 2017 

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