A new scientific statement from the American Heart Association, published today in the journal Circulation, indicates that physical activity may be safer for children and adolescents with certain heart conditions than previously believed. The statement focuses on children with cardiomyopathies—disorders affecting the heart muscle's structure and function—and those with implantable cardioverter-defibrillators (ICDs), devices that detect and correct life-threatening arrhythmias.
While physical activity is essential for childhood development and long-term health, it has traditionally been discouraged in these patients due to fears of worsening heart function or sudden cardiac death. However, the new statement argues that restricting activity can have unintended negative consequences on heart health, physical fitness, mental well-being, and social development. "Children with cardiomyopathy should not automatically be sidelined from participating in physical activity, including recreational or competitive sports," said Jonathan B. Edelson, M.D., chair of the writing group and associate professor at Children's Hospital of Philadelphia.
The statement emphasizes a personalized approach, using tools like echocardiograms, exercise stress tests, and genetic testing to assess individual risk. Shared decision-making among clinicians, families, and patients is crucial to balance risks with the benefits of activity. Close follow-up and reassessment are recommended as children grow and their conditions evolve.
Activities can range from light-to-moderate intensity exercise, such as walking or light cycling, to structured activities like running or organized sports for carefully selected patients. Emergency action plans, including access to automated external defibrillators (AEDs) and bystanders trained in CPR, are essential for organized sports. The statement notes that most research is based on adult data, so findings should be applied cautiously to children.
This statement was prepared by the American Heart Association's Pediatric Heart Failure and Transplantation Committee and other councils. For more details, view the manuscript online at https://www.ahajournals.org/journal/circ. Additional resources are available on the American Heart Association's website at https://www.heart.org.
