Brugada Syndrome and Exercise: Is It Time for a Paradigm Change?

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 a...

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Main Authors: Carolina Miguel Gonçalves, Adriana Vazão, Mariana Carvalho, Margarida Cabral, André Martins, Mónica Amado, Joana Pereira, Fátima Saraiva, Hélia Martins, Hélder Dores
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Journal of Cardiovascular Development and Disease
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Online Access:https://www.mdpi.com/2308-3425/12/3/94
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author Carolina Miguel Gonçalves
Adriana Vazão
Mariana Carvalho
Margarida Cabral
André Martins
Mónica Amado
Joana Pereira
Fátima Saraiva
Hélia Martins
Hélder Dores
author_facet Carolina Miguel Gonçalves
Adriana Vazão
Mariana Carvalho
Margarida Cabral
André Martins
Mónica Amado
Joana Pereira
Fátima Saraiva
Hélia Martins
Hélder Dores
author_sort Carolina Miguel Gonçalves
collection DOAJ
description 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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spelling doaj-art-34cef277af25421e9ae65ced455b4d692025-08-20T03:43:27ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-03-011239410.3390/jcdd12030094Brugada Syndrome and Exercise: Is It Time for a Paradigm Change?Carolina Miguel Gonçalves0Adriana Vazão1Mariana Carvalho2Margarida Cabral3André Martins4Mónica Amado5Joana Pereira6Fátima Saraiva7Hélia Martins8Hélder Dores9Unidade Local de Saúde da Região de Leiria, E.P.E., 2410-197 Leiria, PortugalUnidade Local de Saúde da Região de Leiria, E.P.E., 2410-197 Leiria, PortugalUnidade Local de Saúde da Região de Leiria, E.P.E., 2410-197 Leiria, PortugalUnidade Local de Saúde da Região de Leiria, E.P.E., 2410-197 Leiria, PortugalUnidade Local de Saúde da Região de Leiria, E.P.E., 2410-197 Leiria, PortugalUnidade Local de Saúde da Região de Leiria, E.P.E., 2410-197 Leiria, PortugalUnidade Local de Saúde da Região de Leiria, E.P.E., 2410-197 Leiria, PortugalUnidade Local de Saúde da Região de Leiria, E.P.E., 2410-197 Leiria, PortugalUnidade Local de Saúde da Região de Leiria, E.P.E., 2410-197 Leiria, PortugalPalliative Care Team, Internal Medicine, Emergency and Intensive Care Department, Hospital da Luz, 1500-650 Lisbon, PortugalBackground: 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.https://www.mdpi.com/2308-3425/12/3/94Brugada syndromeexercisesportsathletessudden cardiac deathimplantable cardioverter defibrillator
spellingShingle Carolina Miguel Gonçalves
Adriana Vazão
Mariana Carvalho
Margarida Cabral
André Martins
Mónica Amado
Joana Pereira
Fátima Saraiva
Hélia Martins
Hélder Dores
Brugada Syndrome and Exercise: Is It Time for a Paradigm Change?
Journal of Cardiovascular Development and Disease
Brugada syndrome
exercise
sports
athletes
sudden cardiac death
implantable cardioverter defibrillator
title Brugada Syndrome and Exercise: Is It Time for a Paradigm Change?
title_full Brugada Syndrome and Exercise: Is It Time for a Paradigm Change?
title_fullStr Brugada Syndrome and Exercise: Is It Time for a Paradigm Change?
title_full_unstemmed Brugada Syndrome and Exercise: Is It Time for a Paradigm Change?
title_short Brugada Syndrome and Exercise: Is It Time for a Paradigm Change?
title_sort brugada syndrome and exercise is it time for a paradigm change
topic Brugada syndrome
exercise
sports
athletes
sudden cardiac death
implantable cardioverter defibrillator
url https://www.mdpi.com/2308-3425/12/3/94
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