{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T06:55:21Z","timestamp":1793084121386,"version":"4.5.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,6,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Prior studies have shown a close link between exercise and development of arrhythmogenic right ventricular cardiomyopathy. How much exercise restriction reduces ventricular arrhythmia (VA), how genotype modifies its benefit, and whether it reduces risk sufficiently to defer implantable cardioverter\u2010defibrillator (\n              <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\n              ) placement in arrhythmogenic right ventricular cardiomyopathy are unknown.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We interviewed 129 arrhythmogenic right ventricular cardiomyopathy patients (age: 34.0\u00b114.8 years; male: 60%) with\n              <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\n              s (36% primary prevention) about exercise participation. Exercise change was defined as annual exercise duration and dose in the 3\u00a0years before clinical presentation minus that after presentation. The primary outcome was appropriate\n              <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\n              therapy for VA. During the 5.1 years (interquartile range: 2.7\u201310.8 years) after presentation, 74% (95\/129) patients reduced exercise dose and 85 (66%) patients experienced the primary outcome. In multivariate analyses, top tertile reduction in exercise duration and dose were both associated with less\n              <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>\n              (duration: hazard ratio: 0.23 [95% confidence interval, 0.07\u20130.81]; dose: hazard ratio: 0.14 [95% confidence interval, 0.04\u20130.44]). Greater reduction in exercise dose conferred greater reduction in\n              <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>\n              (\n              <jats:italic>P<\/jats:italic>\n              =0.01 for trend). Patients without desmosomal mutations and those with primary\u2010prevention\n              <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\n              s benefited more from exercise reduction (\n              <jats:italic>P<\/jats:italic>\n              =0.16 and\n              <jats:italic>P<\/jats:italic>\n              =0.06 for interaction); however, 58% (18\/31) of athletes who reduced exercise dose by &gt;80% still experienced\n              <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Exercise restriction should be recommended to all arrhythmogenic right ventricular cardiomyopathy patients with\n              <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\n              s. Patients who are \u201cgene\u2010elusive\u201d and those with primary\u2010prevention devices may particularly benefit. Exercise reduction is unlikely to reduce arrhythmia sufficiently in high\u2010risk patients to alter decision\u2010making regarding\n              <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\n              implantation.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.008843","type":"journal-article","created":{"date-parts":[[2018,6,16]],"date-time":"2018-06-16T09:15:16Z","timestamp":1529140516000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":80,"title":["Impact of Exercise Restriction on Arrhythmic Risk Among Patients With Arrhythmogenic Right Ventricular Cardiomyopathy"],"prefix":"10.1161","volume":"7","author":[{"given":"Weijia","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Orgeron","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crystal","family":"Tichnell","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittney","family":"Murray","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Crosson","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Monfredi","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Cadrin\u2010Tourigny","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harikrishna","family":"Tandri","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugh","family":"Calkins","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia A.","family":"James","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Johns Hopkins University Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","first-page":"3227","article-title":"Treatment of arrhythmogenic right ventricular cardiomyopathy\/dysplasia: an international task force consensus statement","volume":"36","author":"Corrado D","year":"2015","unstructured":"Corrado D, Wichter T, Link MS, Hauer R, Marchlinski F, Anastasakis A, Bauce B, Basso C, Brunckhorst C, Tsatsopoulou A, Tandri H, Paul M, Schmied C, Pelliccia A, Duru F, Protonotarios N, Estes NA III, McKenna WJ, Thiene G, Marcus FI, Calkins H. 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