Table 2.

Summary of recommendations for competitive sports participation and leisure time physical activity according to recent guidelines and consensus documents

Document	Recommendations for competitive sports	Recommendations for leisure time physical activity
2015 AHA/ACC competitive sports eligibility guidelines [52]	• No competitive sports (with the possible exception of skill sports) for possible, borderline or definite ACM • ICD placement for permitting participation in high-intensity sport not recommended	Not addressed
2015 International Task Force Consensus Statement on the Treatment of ARVC [54]	• No competitive sports in patients with definite ACM • Restriction from competitive sports activity may be considered in ACM family members with a negative phenotype, either healthy gene carriers or with unknown genotype	• Low-intensity exercise may be allowed
2019 EAPC recommendations for participation in competitive and leisure time sport in athletes with cardiomyopathies [55]	• No competitive sports in patients with definite or borderline ACM and gene positive/phenotype negative patients	• Low-intensity exercise recommended
2019 HRS guidelines on ACM [56]	• No competitive sports in ACM patients and gene positive/phenotype negative patients	• Frequent high-intensity endurance exercise not advised in ACM patients and gene positive/phenotype negative patients • Preference for low-intensity activities
2020 ESC guidelines sports cardiology and exercise in patients with cardiovascular disease [25]	• No competitive sports of any type in ACM patients and gene positive/phenotype negative patients	• Low-intensity exercise, 150 min/week, for all • Moderate intensity exercise only in low-risk patients* • High intensity not advised

ACM arrhythmogenic cardiomyopathy, ACC American college of cardiology, AHA American heart association, EAPC European association of preventive cardiology, ESC European society of cardiology, ICD implantable cardioverter defibrillator, HRS heart rhythm society

*Low risk = no history of cardiac arrest or ventricular tachycardia, low arrhythmic burden (<500 PVBs/day, no exercise-induced arrhythmias), minimal structural abnormalities