Marrakchi S, Kammoun I, Bennour E, Laroussi L, Ben Miled M, Kachboura S
Cardiology Department, Abderrahmane Mami Hospital, Ariana, Tunisia.
University of Manar II-Medical University of Tunis, 8, Rue 7406 El Manar 1, 2092, Tunis, Tunisia.
Herz. 2020 Apr;45(2):142-157. doi: 10.1007/s00059-018-4706-2. Epub 2018 May 9.
Sudden cardiac death (SCD) in an apparently healthy individual is a tragedy. It is important to identify the cause of death and to prevent SCD in potentially at-risk family members. Inherited primary arrhythmia disorders are associated with exercise-related SCD. Despite the well-known benefits of exercise, exercise restriction has been a historical mainstay of therapy for these conditions. However, since familiarity with inherited arrhythmia conditions has increased and patients are often children and young adults, it is necessary to reassess the treatment guidelines regarding exercise constraints. The aim of this review is to analyze the risk of exercise-induced SCD in patients with inherited cardiac conditions and explore the challenges faced when advising patients about exercise limitations. We searched for publications on cardiac channelopathies in PubMed with the following medical subject headings (MeSH): "long QT syndrome"; "short QT syndrome"; "Brugada syndrome"; and "catecholaminergic polymorphic ventricular tachycardia". The abstracts of these articles were scanned, and articles of relevance, along with pertinent references, were read in full. The analysis was restricted to reports published in English. The findings of this analysis suggest that exercise with low-to-moderate cardiovascular demand may be possible under regular clinical follow-up in inherited primary arrhythmia disorders. Recent data show that patients with inherited primary arrhythmia disorders are at low risk for events once a comprehensive treatment program has been established. Recreational activity is likely safe for these individuals, with personalized management based on individual patient preferences and priorities.
健康个体突发心源性猝死（SCD）是一场悲剧。确定死因并预防有潜在风险的家庭成员发生SCD非常重要。遗传性原发性心律失常疾病与运动相关的SCD有关。尽管运动有诸多益处，但限制运动一直是治疗这些疾病的主要手段。然而，随着对遗传性心律失常疾病的了解增多，且患者往往是儿童和年轻人，有必要重新评估关于运动限制的治疗指南。本综述的目的是分析遗传性心脏病患者运动诱发SCD的风险，并探讨在向患者提供运动限制建议时所面临的挑战。我们在PubMed上使用以下医学主题词（MeSH）搜索关于心脏离子通道病的出版物：“长QT综合征”；“短QT综合征”；“Brugada综合征”；以及“儿茶酚胺能多形性室性心动过速”。扫描这些文章的摘要，并全文阅读相关文章及相关参考文献。分析仅限于英文发表的报告。该分析结果表明，在遗传性原发性心律失常疾病的常规临床随访下，进行低至中等心血管需求的运动可能是可行的。最新数据显示，一旦建立了全面的治疗方案，遗传性原发性心律失常疾病患者发生事件的风险较低。对于这些个体，娱乐活动可能是安全的，可根据患者的个人偏好和优先级进行个性化管理。
