Physical Activity May Be Safer Than Thought for Children with Certain Heart Conditions, New Statement Says
The American Heart Association's new scientific statement suggests that with proper evaluation and monitoring, physical activity can be beneficial for children with cardiomyopathies or implantable cardioverter-defibrillators, shifting away from blanket restrictions.
The American Heart Association has released a new scientific statement suggesting that physical activity may be safer than previously believed for children and adolescents with certain heart conditions, including cardiomyopathies and those with implantable cardioverter-defibrillators (ICDs). Published today in the Association's flagship journal Circulation, the statement emphasizes that personalized guidance and shared decision-making are critical to balancing risks and benefits.
Traditionally, children with these conditions have been discouraged from physical activity due to fears of worsening heart function or sudden cardiac death. However, the new research indicates that restricting movement can negatively impact heart health, physical fitness, mental well-being, social development, and quality of life. "While safety is always paramount, halting all physical activity among children with cardiomyopathy or ICDs has at times led to unintended consequences," said Dr. Jonathan B. Edelson, chair of the statement writing group and associate professor of pediatrics at Children's Hospital of Philadelphia.
The statement calls for a personalized approach, using tools such as echocardiograms, cardiac imaging, exercise stress tests, and genetic testing to assess individual risk. Shared decision-making among clinicians, families, and patients is essential to balance risk with personal goals. Close follow-up and reassessment are also crucial as children grow and their conditions evolve.
The statement shifts away from a one-size-fits-all approach, suggesting that light-to-moderate activities like walking, cycling, or swimming may be appropriate for many. For some carefully selected patients, even competitive sports may be reasonable after expert assessment. Emergency action plans, including access to automated external defibrillators (AEDs) and bystanders trained in CPR, are emphasized for organized sports.
"Children with cardiomyopathy should not automatically be sidelined from participating in physical activity," Edelson said. The statement highlights the need for more research, as most findings are based on adult observational studies, and questions remain about how exercise affects long-term disease progression in children.
The statement was prepared by the American Heart Association's Pediatric Heart Failure and Transplantation Committee and other councils. It aims to inform health care decisions and calls for ongoing monitoring and individualized plans. For more information, see the full statement in Circulation and additional resources on heart.org.