Physical activity volume in patients with arrhythmogenic cardiomyopathy is associated with recurrence after ventricular tachycardia ablation

Purpose: To assess the role of intense physical activity (PA) on recurrence after ventricular tachycardia (VT) ablation in arrhythmogenic cardiomyopathy (ACM). Methods: We retrospectively analyzed 63 patients with definite diagnosis of ACM who underwent to catheter ablation (CA) of VT. PA was quantified in METs per week by IPAQ questionnaire in 51 patients. VT-free survival time after ablation was analyzed by Kaplan–Meier’s curves. Results: The weekly amount of PA was higher in patients with VT recurrence (2303.1 METs vs 1043.5 METs, p = 0.042). The best cutoff to predict VT recurrence after CA was 584 METs/week (AUC = 0.66, sensibility = 85.0%, specificity = 45.2%). Based on this cutoff, 34 patients were defined as high level athletes (Hi-PA) and 17 patients as low-level athletes (Lo-PA). During a median follow-up of 32.0 months (11.5–65.5), 22 patients (34.9%) experienced VT recurrence. Lo-PA patients had a longer VT-free survival, compared with Hi-PA patients (82.4% vs 50.0%, log-rank p = 0.025). At Cox multivariate analysis, independent predictors of the VT recurrence were PA ≥ 584 METs/week (Hi-PA) (HR = 2.61, CI 95% 1.03–6.58, p = 0.04) and late potential (LP) abolition (HR = 0.38, CI 95% 0.16–0.89, p = 0.03). Conclusions: PA ≥ 584 METs/week and LP abolition were independent predictors of VT recurrence after ablation.