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New Insights in Exercise for Arrhythmogenic Cardiomyopathy: A Narrative Review
Alwaleed Aljohar1,2, Zachary Laksman1,3, Noah Boroditsky1
1Sports Cardiology BC, University of British Columbia Hospital, Vancouver, British Columbia, Canada.
CJC Open
|May 18, 2026
Summary
Arrhythmogenic cardiomyopathy (ACM) is an inherited heart condition influenced by exercise. This review addresses exercise prescription for ACM patients and their families, aiming for safer activity guidelines.
Area of Science:
- Cardiology
- Genetics
- Sports Medicine
Background:
- Arrhythmogenic cardiomyopathy (ACM) is an inherited cardiac condition and a significant cause of sudden cardiac death in athletes.
- While genetic factors are primary, exercise significantly modulates ACM prognosis and outcomes.
- Knowledge gaps exist regarding exercise's impact on ACM subtypes and at-risk individuals.
Purpose of the Study:
- To review the impact of exercise on various arrhythmogenic cardiomyopathy subtypes.
- To address concerns regarding exercise prescription for ACM patients and genotype-positive, phenotype-negative family members.
- To propose a practical approach for exercise prescription in arrhythmogenic cardiomyopathy.
Main Methods:
- Literature review focusing on arrhythmogenic cardiomyopathy and exercise.
- Analysis of genotype-phenotype correlations and exercise response.
- Examination of current exercise recommendations and limitations.
Main Results:
- Exercise intensity and type significantly influence ACM outcomes, varying by genotype.
- Current exercise advice for ACM patients lacks objectivity and defined safe thresholds.
- Consensus is needed for exercise guidance in asymptomatic gene carriers.
Conclusions:
- Personalized exercise prescription is crucial for managing arrhythmogenic cardiomyopathy.
- Further research is needed to establish safe exercise thresholds for ACM patients.
- Clearer guidelines are required for both affected individuals and at-risk family members.
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