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Sports_SVT_Overview.html
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<!DOCTYPE html>
<html lang="en">
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<meta name="viewport" content="width=device-width, initial-scale=1" />
<head>
<meta charset="UTF-8">
<title>CardioRef: AHA/ACC 2015 Sports Participation Selector Guide: EAT, AVNRT, etc.</title>
<link rel="stylesheet" href="css/sports_answer_combined.css">
<style>
div{
-webkit-margin-before:0;
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</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.0000000000000245">
Reference: ACC/AHA Sports Participation Recommendations (Circulation 2015)
Task Force 9: Arrhythmias and Conduction Defects</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>AV Nodal Reentry Tachycardia, AV Reciprocating Tachycardia, or Atrial 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" class="active">EAT, AVNRT, AVRT, & WPW</a>
<a href="Sports_PVC_Overview.html" >PVCs</a>
<a href="Sports_NSVT_Overview.html">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>EAT, AVNRT, AVRT, or WPW</h2>
<hr>
<section id="needtoknow">
<p class="sectiontitle">Should perform:</p>
<ul>
<li>ECG</li>
<li>Echocardiogram</li>
</ul>
<p>"Athletes with regular, acute-onset SVTs should undergo cardiac assessment
with ECG and echocardiogram."</p>
<p class="rec_class">(Class I Recommendation; Level of Evidence B)</p>
</section>
<p></p>
<hr width="70%">
<section id="answer">
<section class="third_left">
<p class="sectiontitle">Regular, acute-onset, symptomatic SVT</p>
<p>"The treatment of choice for athletes with regular, acute-onset,
symptomatic SVTs should be catheter ablation."
</p>
<div class="verdict_no"><b>Consider ablation</b></div>
<p class="rec_class">(Class I Recommendation; Level of Evidence C)</p>
</section>
<section class="third_middle">
<p class="sectiontitle">Short refractory period bypass tracts, h/o AF</p>
<p>"Athletes with short refractory period bypass tracts capable of anterograde conduction
and a history of paroxysmal AF should have an ablation of the accessory pathway
before clearance for competitive sports because of risk for life-threatening arrhythmias."
</p>
<div class="verdict_no"><b>Should have ablation before clearance for sports</b></div>
<p class="rec_class"> (Class I Recommendation; Level of Evidence B)</p>
</section>
<section class="third_right">
<p class="sectiontitle">Asymptomatic preexcitation</p>
<p>"In athletes with asymptomatic preexcitation, it is reasonable to attempt risk stratification with stress testing
to determine whether the preexcitation abruptly terminates at low heart rates.
If low risk is unclear, it is reasonable to recommend invasive electrophysiological evaluation,
with ablation of the bypass tract if it is deemed high risk for SCD because of a refractory period ≤250 ms."
</p>
<div class="verdict_maybe"><b>Reasonable to do stress test.</b> May consider EP study depending on stress test results.</div>
<p class="rec_class">(Class IIa Recommendation; Level of Evidence B)</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>EAT = ectopic atrial tachycardia, AVNRT = AV nodal reentrant tachycardia, AVRT = AV reciprocating tachycardia, WPW = Wolff-Parkinson-White, AF = atrial fibrillation, SVT = supraventricular tachycardia, SCD = sudden cardiac death, EP = electrophysiology
</p>
</section>
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