Lifestyle physical activity intensity and rapid-rate non-sustained ventricular tachycardia in arrhythmogenic cardiomyopathy

Objectives This study aimed to investigate the association of accelerometer-measured lifestyle physical activity with the incidence of rapid-rate non-sustained ventricular tachycardias (RR-NSVT) during a 30-day recording period in AC patients. Methods This multicenter, observational study enrolled 72 AC patients, including right, left-, and biventricular forms of the disease, with underlying desmosomal and non desmosomal mutations. Lifestyle physical activity was objectively monitored with accelerometers (i.e., movement sensors), and RR-NSVT were identified from a textile Holter electrocardiogram (ECG) for 30 days as those faster than 188 bpm and longer than 18 beats. Results Sixty-three AC patients (38±17.6 years, 57% men) provided data on physical activity and ventricular tachycardias. A total of 17 patients experienced 1 ≥ RR-NSVTs, and a total of 35 events were recorded. Participants presenting RR-NSVTs during the 30-day measurement (n=17) did not perform more lifestyle physical activity ( P =0.734), neither more activities of moderate-to-vigorous intensity ( P =0.245) than their peers without RR-NSVTs in this period. Likewise, participants with RR-NSVTs did not increase their activity level, neither the activities of any intensity (−5 min/day on average) nor those of moderate-to-vigorous intensity (+2 min/day on average) in the days of RR-NSVTs occurrence. Finally, we observed that around half of the RR-NSVTs recorded in the 30 days occurred at rest (i.e., 19 RR-NSVTs), and the other half occurred after or during physical activity (i.e.,16 RR-NSVTs). Conclusion These findings suggest that lifestyle physical activity, mainly of light and moderate intensity, does not increase the risk for RR-NSVTs in AC patients. Summary box What is already known Arrhythmogenic cardiomyopathy (AC) is associated to sport-triggered sudden cardiac death Competitive sports and high-intensity exercise are contraindicated in AC patients Rapid-rate non-sustained ventricular arrhythmias (RR-NSVT) are a surrogate of sudden cardiac death in this population What this study adds Conscious investigation on the relationship between lifestyle physical activity of different intensities with ventricular arrhythmias in AC patients Accelerometer-measured lifestyle physical activity, mainly of light and moderate intensity, seem not to be associated with the occurrence of RR-NSVTs How this study might affect clinical practice in the future This study provides strong evidence for the promotion of lifestyle physical activity among AC patients to ensure they obtain the multiple benefits and risk reductions associated with physical activity