Key result
Exercise is not an independent predictor of sudden cardiac death in Brugada Syndrome, prompting less restrictive recommendations that allow asymptomatic patients to participate in competitive sports.
Why the study?
Although exercise offers multiple health benefits, it can trigger adverse clinical events including sudden cardiac death in individuals with arrhythmic disorders such as Brugada Syndrome.
Does physical activity and exercise increase the risk of sudden cardiac death in individuals with Brugada Syndrome?
Does physical activity and exercise increase the risk of sudden cardiac death in individuals with Brugada Syndrome?
Exercise is not an independent predictor of sudden cardiac death in Brugada Syndrome, supporting a shift towards less restrictive sports participation recommendations for asymptomatic patients.
Exercise in BrS requires individualized risk assessment; leaves open the need for prospective trials to refine thresholds.
BACKGROUND: Despite the multiple benefits of exercise for health, exercise in the presence of arrhythmic disorders can trigger adverse clinical events, including sudden cardiac death (SCD). The aim of this narrative review is to summarize the most recent recommendations regarding physical activity and exercise in individuals with Brugada Syndrome (BrS). METHODS: An advanced literature search was performed on the Pubmed and clinicaltrials.gov databases and published articles/clinical trials registered until September 2024 were analyzed. The final analysis included 33 articles. RESULTS: Despite initial reports suggesting a higher risk of SCD in BrS, the risk is not as high as expected, and there is no evidence that exercise is an independent predictor. Therefore, scientific recommendations have become less restrictive. However, consensus on risk scores is lacking, making the evaluation of BrS a real challenge. The most recent recommendations emphasize individual evaluation, risk stratification, shared decision-making, and general preventive measures, allowing asymptomatic BrS patients as well as genotype positive/phenotype negative patients to participate in competitive sports, excluding sports under extreme conditions. Regarding patients with an implantable cardioverter defibrillator, both leisure and competitive sports may be considered in asymptomatic patients, avoiding contact sports. CONCLUSIONS: Research on the relationship between exercise and cardiovascular disease is evolving, but evidence-based recommendations for sports in BrS patients are scarce and further studies are needed.
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Gonçalves et al. (2025) conducted a review in Brugada Syndrome (n=33). Physical activity and exercise was evaluated. Exercise is not an independent predictor of sudden cardiac death in Brugada Syndrome, prompting less restrictive recommendations that allow asymptomatic patients to participate in competitive sports.
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