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Sports_NSVT_Overview.html
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<!DOCTYPE html>
<html lang="en">
<!-- defines the default zoom for mobile devices -->
<meta name="viewport" content="width=device-width, initial-scale=1" />
<head>
<meta charset="UTF-8">
<title>CardioRef: AHA/ACC 2015 Sports Participation Selector Guide: Non-Sustained Ventricular Tachycardia</title>
<link rel="stylesheet" href="css/sports_answer_combined.css">
<style>
div{
-webkit-margin-before:0;
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-webkit-margin-start:0;
-webkit-margin-end:0;
}
</style>
</head>
<body>
<div class="topbar">
<a href="index.html">Pedi CardioRef</a>
<div class="guidelinebar">
<a target="_blank" rel="noopener noreferrer" href="https://www.ahajournals.org/doi/10.1161/CIR.0000000000000239">
Reference: ACC/AHA Sports Participation Recommendations (Circulation 2015)
Task Force 9</a>
</div>
</div>
<section style="margin:10px">
<p class="topspace"></p>
<label><b>By the ACC/AHA 2015 guidelines, should my patient with</label>
<select name="disease" id="dz" class="InputBox" onChange="goThere();">
<option value="">*Select Disease*</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="HCM">Hypertrophic Cardiomyopathy </option>
<option value="LVNC">Left Ventricular Non-Compaction </option>
<option value="DilRestr">Dilated or Restrictive Cardiomyopathy </option>
<option value="ARVC">Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) </option>
<option value="Myo">Myocarditis </option>
<option value="Peri">Pericarditis </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="ASDVSDPDA">ASD, VSD, or PDA </option>
<option value="PS">Pulmonic Stenosis </option>
<option value="AS">Aortic Stenosis </option>
<option value="Coarct">Coarctation </option>
<option value="Cyan">Cyanotic Heart Disease, unrepaired or with palliative shunt </option>
<option value="TOF">Tetralogy of Fallot, s/p repair </option>
<option value="TGA_Must">d-transposition (d-TGA), s/p atrial switch (Mustard/Senning)</option>
<option value="TGA_Art">d-transposition (d-TGA), s/p arterial switch </option>
<option value="CCTGA">Congenitally-corrected TGA (CC-TGA, L-TGA)</option>
<option value="Fontan">Fontan </option>
<option value="Ebstein">Ebstein Anomaly </option>
<option value="AnomCoronary">Anomalous Coronary Artery Origin</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="PVR">Elevated PVR in CHD </option>
<option value="VentricularDysfxn">Ventricular Dysfunction s/p CHD Surgery</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="Valve_AS">Aortic Stenosis</option>
<option value="Valve_AR">Aortic Regurgitation </option>
<option value="Valve_MS">Mitral Stenosis</option>
<option value="Valve_MR">Mitral Regurgitation </option>
<option value="Valve_Hx">History of Mitral or Aortic Valve Surgery</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="HTN">Hypertension </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="AoDiseases_and_Marfan">Aortic Diseases and Marfan Syndrome</option>
<option value="BAV">Bicuspid Aortic Valve</option>
<option value="Marfan">Marfan Syndrome</option>
<option value="TAA">Thoracic Aortic Aneurysm, familial or unexplained</option>
<option value="LoeysDietz_EhlersDanlos">Loeys-Dietz or vascular Ehlers-Danlos</option>
<option value="AoEnlarge">Enlarged Aorta, non-syndrome non-familial</option>
<option value="Ao_Surgery">S/p Surgery for Aortic Enlargement/Dissection</option>
<option value="Chronic_AoDissection">Chronic Aortic Dissection or Branch Aneurysm</option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="CoronaryOverview">Coronary Artery Disease </option>
<option value ="" class="dropdown-divider">---------------------------------------------------------------</option>
<option value="Syncope">Syncope </option>
<option value="Arrhythmia">Arrhythmias (SVT, PVC, Vtach, etc.) </option>
<option value="ConductionDefect">Conduction Defects (AV block, brady, pacemaker, RBBB/LBBB)</option>
<option value="Channelopathies">Channelopathies (LQTS, CPVT, Brugada, etc.) </option>
<option value="ICD">Implantable Cardioverter-Defibrillator (ICD) </option>
</select>
<span>participate in organized sports?</span></b>
<br><br>
<section id="question">
Should my patient with <b>Non-Sustained Ventricular Tachycardia</b> participate in organized sports?
</section>
</section>
<!-- End of 10px margin section. Consider changing template. -->
<br>
<!-- navigation bar for disease sub-categories -->
<nav>
<a href="Sports_Afib_Overview.html">Atrial Fibrillation</a>
<a href="Sports_Aflutter_Overview.html">Atrial Flutter</a>
<a href="Sports_SVT_Overview.html">EAT, AVNRT, AVRT, & WPW</a>
<a href="Sports_PVC_Overview.html">PVCs</a>
<a href="Sports_NSVT_Overview.html" class="active">Non-sustained ventricular tachycardia (NSVT)</a>
<a href="Sports_VT_mono_Overview.html">Monomorphic VT, sustained</a>
<a href="Sports_VT_poly_Overview.html">Polymorphic VT or VF, sustained</a>
</nav>
<div class="largeanswerbox">
<h2 align=center>Non-Sustained Ventricular Tachycardia (NSVT)</h2>
<h3 align=center>Definition: ≥3 consecutive PVCs up to a maximum duration of 30 seconds of repetitive activity that does not provoke cardiovascular collapse</h3>
<hr>
<!-- <section class="single_center">
Definition: ≥3 consecutive PVCs up to a maximum duration of 30 seconds of repetitive activity that does not provoke cardiovascular collapse
</section> -->
<p></p>
<section id="needtoknow">
<p class="sectiontitle">Need to know:</p>
<ul>
<li>Structrually normal heart?</li>
<li>Max performance exercise stress test findings</li>
<li>Myocarditis?</li>
</ul>
</section>
<section id="answer_arrow_section">
<section class="third_invisible">⇙</section>
<section class="third_invisible">⇓</section>
<section class="third_invisible">⇘</section>
</section>
<section id="answer">
<section class="third_left">
<p class="sectiontitle">Structrually <u>normal</u> heart, no molecular/genetic/inflammatory disorder, suppression of arrhythmia with exercise</p>
<p>"Athletes with a structurally normal heart and no evidence of molecular/genetic or inflammatory disorders
with suppression of the arrhythmia during exercise can participate in competitive athletics at any level.
</p><p>The exercise testing protocol should be based on <u>maximum performance</u> rather than achieving 80 to 100%
of the target heart rate to come as close as possible to the level of exertion achieved during the athlete’s
competitive sport.</p><p>
Consideration of advanced therapy such as catheter ablation in an attempt to cure the runs of NSVT is optional."
</p>
<div class="verdict_ok"><b>Can participate in all sports, if above conditions met</b>, including max performance exercise test</div>
<p class="rec_class">(Class I Recommendation; Level of Evidence C)</p>
</section>
<section class="third_middle">
<p class="sectiontitle">Structrually <u>normal</u> heart, NSVT suppressed by medication</p>
<p>"For athletes without structural heart disease who have NSVT that is suppressed by drug therapy,
especially β-blockers, documentation of both ambient and exercise-induced NSVT should be required
before general clearance for participation in higher-level competitive athletics. </p>
<p>Specifically, the athlete should not compete in sports with a classification greater than
IA <u>unless</u> it is documented by exercise testing or electrophysiological testing that the arrhythmia
is no longer inducible under the circumstances in which it was induced before therapy. β-Blockers might exacerbate exercise-induced asthma."
</p>
<div class="verdict_maybe"><b>Restrict to no more than IA sports</b> unless testing shows VT no longer inducible</div>
<p class="rec_class"> (Class I Recommendation; Level of Evidence C)</p>
</section>
<section class="third_right">
<p class="sectiontitle">Structrually <u>abnormal</u> heart, or active myocarditis</p>
<p>"Athletes with structural disorders or active myocarditis and documented NSVT should only participate in
low-intensity class IA sports. In the case of myocarditis, reevaluation is recommended after there is
clinical and laboratory evidence of healing of the myocarditis, with return to athletics a minimum of 3 months
after clinical resolution."
</p>
<div class="verdict_maybe"><b>Limit to low-intensity class IA sports</b></div><br>
<div class="verdict_maybe"><b>For myocarditis:</b> Reevaluate >3 months after clinical resolution</div>
<p class="rec_class">(Class I Recommendation; Level of Evidence C)</p>
<p>See also: <a href="Sports_Myo_Overview.html">Myocarditis sports participation guidelines</a></p>
</section>
</section>
</div>
<p class="foot">
<b>Reference:</b> <a href="https://www.ahajournals.org/doi/10.1161/CIR.0000000000000245"><i>Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 9.</a>
A Scientific Statement From the AHA and ACC. Circulation 2015</i>
<br><br><b>Disclaimer:</b> This website is derived from published guidelines, but does not constitute medical advice nor does it replace clinical judgement. Only the text in quotation marks are direct quotations from the original guidelines. Text not in quotations as well as the method of information display are all that of the website creator and are not part of the original published guidelines. Please consult a physician to discuss any patient-specific matters.
</p>
<section class="key">
<p><b>Key:</b> NSVT = non-sustained ventricular tachycardia, VT = ventricular tachycardia
</p>
</section>
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