A new scientific statement from the American Heart Association, published today in Circulation, suggests that physical activity in children and teenagers with cardiomyopathy or implantable cardioverter-defibrillators (ICDs) may be safer than previous research indicated. The statement highlights that while safety remains paramount, restricting all physical activity can negatively impact heart health, physical fitness, mental well-being, social development, and quality of life.
“The latest research indicates that restricting children’s movement can negatively affect their heart health, physical fitness levels, mental well-being and social development, and quality of life,” said Jonathan B. Edelson, M.D., M.S.C.E., chair of the scientific statement writing group. The statement emphasizes a personalized approach, shared decision-making, and close follow-up to guide safe participation in physical activities.
Key recommendations include tailored risk assessments using diagnostic tools such as echocardiograms, exercise stress tests, and genetic testing. Clinicians are urged to work with families and patients to balance risk with goals and values, and to disclose when evidence is based on adult data. Ongoing monitoring is critical to adjust recommendations as the child grows and the condition evolves.
The statement shifts from a one-size-fits-all approach to considering safe participation in activities ranging from light-to-moderate exercise (e.g., walking, light cycling) to structured physical activity (e.g., strength training, running, biking) and, for select patients, competitive sports after expert assessment. Emergency action plans, including AED access and bystanders trained in CPR, are essential during organized sports.
“Children with cardiomyopathy should not automatically be sidelined from participating in physical activity, including recreational or competitive sports,” Edelson said. The statement notes that most findings are based on adult observational studies, so caution is needed when applying them to children. More research is needed on how exercise affects long-term progression and risk across different cardiomyopathies.
The statement was prepared by the American Heart Association’s Pediatric Heart Failure and Transplantation Committee and other councils. It reinforces that physical activity is vital for childhood development and long-term health, and with proper evaluation, many children with heart conditions can safely participate.
For more information, view the full statement online at Circulation.
