CardioRef: AHA/ACC 2015 Sports Participation Selector Guide: Second-Degree AV Block, Type 1 (Wenckebach)

Need to know:

Symptomatic?
Structurally normal heart?
Exercise study results
Co-existing bundle-branch block
Evidence of risk of progression to higher-degree AV block

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Asymptomatic, structurally normal, improvement with exercise or recovery

"Asymptomatic athletes with structurally normal hearts and Wenckebach AV block (type I second-degree AV block) with improvement in conduction with exercise or recovery can participate in all competitive sports."

All sports = acceptable

(Class I Recommendation; Level of Evidence C)

Asymptomatic, structurally abnormal, improvement with exercise

"Asymptomatic athletes with structurally abnormal hearts with improvement in Wenckebach AV block with exercise can participate in all competitive sports, unless there are restrictions based on heart disease."

All sports = acceptable unless restrictions based on heart disease

(Class I Recommendation; Level of Evidence C)

Wenckebach that doesn't improve with exercise

"Athletes with Wenckebach AV block that does not improve with exercise should be evaluated with an EPS for intra-His or infra-His block that may require pacemaker therapy."

Should get EP study

(Class I Recommendation; Level of Evidence C)

Bundle-branch block or risk of progression to higher-degree AV block

"In athletes with Wenckebach AV block and coexisting bundle-branch block or with any indication that they are at risk for progression to higher-degree AV block, EPS should be performed to identify the presence of intra–His-Purkinje or infra–His-Purkinje block that may require pacemaker therapy."

Should get EP study

(Class I Recommendation; Level of Evidence C)

Reference: Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 9: Arrhythmias and Conduction Defects. A Scientific Statement From the AHA and ACC. Circulation 2015

Disclaimer: This website is derived from published guidelines, but does not constitute medical advice nor does it replace clinical judgement. Only the text in quotation marks are direct quotations from the original guidelines. Text not in quotations as well as the method of information display are all that of the website creator and are not part of the original published guidelines. Please consult a physician to discuss any patient-specific matters.