Specific Cardiovascular Diseases and Competitive Sports Participation: Channelopathies

Long QT Syndrome, Short QT Syndrome, Brugada Syndrome and Catecholaminergic Polymorphic Ventricular Tachycardia are inherited primary disorders with the common denominators of a genetic basis and absence of structural abnormalities. They are clinically relevant as the manifestation ranges from absence of symptoms, syncopal episodes, to sudden cardiac death. In Long QT Syndrome and Catecholaminergic Polymorphic Ventricular Tachycardia cardiac events occur either during exercise or emotional stress in otherwise healthy young individuals, being therefore quite relevant for sport physicians. By contrast, in Brugada Syndrome events mainly manifest in resting condition and when there is an increase in the vagal tone; while in Short QT Syndrome trigger is quite variable. The correct diagnosis may be challenging sometimes, but it is crucial as very effective therapies are available and can drastically reduce the risk of life-threatening arrhythmias. Restriction from competitive sport is warranted, although the recommendations are under national regulation that are quite different even within European Countries. However, at least for Long QT Syndrome and Catecholaminergic Polymorphic Ventricular Tachycardia there is a wide consensus that restriction for competitive sport should be applied. This chapter will review the principal features of these diseases, with a primary focus on diagnosis and clinical management.