Italian Cardiological Guidelines (COCIS) for Competitive Sport Eligibility in athletes with heart disease: update 2024

Paolo Zeppilli¹, Alessandro Biffi², Michela Cammarano¹, Silvia Castelletti³, Elena Cavarretta^{4

5}, Franco Cecchi⁶, Furio Colivicchi⁷, Maurizio Contursi⁸, Domenico Corrado⁹, Antonello D'Andrea¹⁰, Francesco Deferrari¹¹, Pietro Delise^{12

13

14}, Antonio Dello Russo¹⁵, Domenico Gabrielli¹⁶, Franco Giada¹⁷, Ciro Indolfi¹⁸, Viviana Maestrini^{19

20}, Giuseppe Mascia²¹, Lucio Mos²², Fabrizio Oliva²³, Zefferino Palamà^{23

24

25}, Stefano Palermi²⁶, Vincenzo Palmieri¹, Giampiero Patrizi²⁷, Antonio Pelliccia²⁰, Pasquale Perrone Filardi²⁸, Italo Porto^{21

29}, Peter J Schwartz³⁰, Marco Scorcu³¹, Fabrizio Sollazzo¹, Andrea Spampinato³², Andrea Verzeletti³³, Alessandro Zorzi⁹, Flavio D'Ascenzi³⁴, Maurizio Casasco^{31

35}, Luigi Sciarra²⁴

Affiliations

¹ Unit of Sports Medicine, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy.
² Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy.
³ Department of Cardiology, IRCSS Istituto Auxologico Italiano, Milan, Italy.
⁴ Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
⁵ Advanced Cardiovascular Therapies Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
⁶ Cardiomyopathy Unit and Genetic Unit, Careggi University Hospital, Florence, Italy.
⁷ Department of Clinical and Rehabilitation Cardiology, Ospedale San Filippo Neri, Rome, Italy.
⁸ Centro Polispecialistico Check-up, Cardiologia dello Sport, Salerno, Italy.
⁹ Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy.
¹⁰ Department of Cardiology, Umberto I Hospital, Nocera Inferiore, Salerno, Italy.
¹¹ Institute of Legal Medicine, University of Brescia, Brescia, Italy.
¹² Unit of Cardiology, P. Pederzoli Hospital, Peschiera del Garda, Verona, Italy.
¹³ Medical Center, Poliambulatorio di Mestre, Venice, Italy.
¹⁴ Medical Center, Poliambulatorio di Conegliano, Treviso, Italy.
¹⁵ Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy.
¹⁶ Division of Cardiology, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy.
¹⁷ Unit of Sports Medicine and Cardiovascular Rehabilitation, Cardiovascular Department, PF Calvi Hospital, Venice, Italy.
¹⁸ Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.
¹⁹ Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University, Rome, Italy.
²⁰ Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy.
²¹ Dipartimento CardioToracoVascolare, Clinica delle Malattie Cardiovascolari, Ospedale Policlinico San Martino IRCCS, Genoa, Italy.
²² San Antonio Hospital, San Daniele del Friuli, Udine, Italy.
²³ De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy.
²⁴ Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
²⁵ Unit of Cardiology, Casa di Cura Villa Verde, Taranto, Italy.
²⁶ Public Health Department, University of Naples Federico II, Naples, Italy.
²⁷ Department of Cardiology, Carpi Hospital, Carpi, Modena, Italy.
²⁸ Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy.
²⁹ Unità di Cardiologia, Dipartimento di Medicina Interna e Specialità Mediche - DiMi, Università di Genova, Genoa, Italy.
³⁰ Center for Cardiac Arrhythmias of Genetic Origin, IRCCS Istituto Auxologico Italiano, Milan, Italy.
³¹ Federazione Medico Sportiva Italiana (FMSI), Rome, Italy.
³² Department of Cardiology, Villa Tiberia Nursing Home, Rome, Italy.
³³ Department of Medical and Surgical Specialities, University of Brescia, Brescia, Italy.
³⁴ Department of Medical Biotechnologies, Sports Cardiology and Rehab Unit, University of Siena, Siena, Italy - flavio.dascenzi@unisi.it.
³⁵ European Federation of Sport Medicine Association (EFSMA), Lausanne, Switzerland.

PMID: 39435618
DOI: 10.23736/S0026-4806.24.09519-3

Free article

Practice Guideline

Italian Cardiological Guidelines (COCIS) for Competitive Sport Eligibility in athletes with heart disease: update 2024

Paolo Zeppilli et al. Minerva Med. 2024 Oct.

Free article

. 2024 Oct;115(5):533-564.

doi: 10.23736/S0026-4806.24.09519-3.

Authors

Affiliations

¹ Unit of Sports Medicine, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy.
² Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy.
³ Department of Cardiology, IRCSS Istituto Auxologico Italiano, Milan, Italy.
⁴ Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
⁵ Advanced Cardiovascular Therapies Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
⁶ Cardiomyopathy Unit and Genetic Unit, Careggi University Hospital, Florence, Italy.
⁷ Department of Clinical and Rehabilitation Cardiology, Ospedale San Filippo Neri, Rome, Italy.
⁸ Centro Polispecialistico Check-up, Cardiologia dello Sport, Salerno, Italy.
⁹ Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy.
¹⁰ Department of Cardiology, Umberto I Hospital, Nocera Inferiore, Salerno, Italy.
¹¹ Institute of Legal Medicine, University of Brescia, Brescia, Italy.
¹² Unit of Cardiology, P. Pederzoli Hospital, Peschiera del Garda, Verona, Italy.
¹³ Medical Center, Poliambulatorio di Mestre, Venice, Italy.
¹⁴ Medical Center, Poliambulatorio di Conegliano, Treviso, Italy.
¹⁵ Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy.
¹⁶ Division of Cardiology, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy.
¹⁷ Unit of Sports Medicine and Cardiovascular Rehabilitation, Cardiovascular Department, PF Calvi Hospital, Venice, Italy.
¹⁸ Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.
¹⁹ Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University, Rome, Italy.
²⁰ Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy.
²¹ Dipartimento CardioToracoVascolare, Clinica delle Malattie Cardiovascolari, Ospedale Policlinico San Martino IRCCS, Genoa, Italy.
²² San Antonio Hospital, San Daniele del Friuli, Udine, Italy.
²³ De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy.
²⁴ Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
²⁵ Unit of Cardiology, Casa di Cura Villa Verde, Taranto, Italy.
²⁶ Public Health Department, University of Naples Federico II, Naples, Italy.
²⁷ Department of Cardiology, Carpi Hospital, Carpi, Modena, Italy.
²⁸ Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy.
²⁹ Unità di Cardiologia, Dipartimento di Medicina Interna e Specialità Mediche - DiMi, Università di Genova, Genoa, Italy.
³⁰ Center for Cardiac Arrhythmias of Genetic Origin, IRCCS Istituto Auxologico Italiano, Milan, Italy.
³¹ Federazione Medico Sportiva Italiana (FMSI), Rome, Italy.
³² Department of Cardiology, Villa Tiberia Nursing Home, Rome, Italy.
³³ Department of Medical and Surgical Specialities, University of Brescia, Brescia, Italy.
³⁴ Department of Medical Biotechnologies, Sports Cardiology and Rehab Unit, University of Siena, Siena, Italy - flavio.dascenzi@unisi.it.
³⁵ European Federation of Sport Medicine Association (EFSMA), Lausanne, Switzerland.

PMID: 39435618
DOI: 10.23736/S0026-4806.24.09519-3

Abstract

Nearly 35 years after its initial publication in 1989, the Italian Society of Sports Cardiology and the Italian Federation of Sports Medicine (FMSI), in collaboration with other leading Italian Cardiological Scientific Associations (ANCE - National Association of Outpatient Cardiology, ANMCO - National Association of Inpatient Cardiology, SIC - Italian Society of Cardiology), proudly present the 2023 version of the Cardiological Guidelines for Competitive Sports Eligibility. This publication is an update of the previous guidelines, offering a comprehensive and detailed guide for the participation of athletes with heart disease in sports. This edition incorporates the latest advances in cardiology and sports medicine, providing current information and recommendations. It addresses various topics, including the details of the pre-participation screening in Italy and recommendations for sports eligibility and disqualification in competitive athletes with various heart conditions. This revised version of the Cardiological Guidelines for Competitive Sports Eligibility, recorded in the Italian Guidelines Registry of the Italian Minister of Health, stands as a crucial resource for sports medicine professionals, cardiologists, and healthcare providers, marked by its completeness, reliability, and scientific thoroughness. It is an indispensable tool for those involved in the care, management and eligibility process of competitive athletes with heart conditions.

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Italian Cardiological Guidelines (COCIS) for Competitive Sport Eligibility in athletes with heart disease: update 2024

Affiliations

Italian Cardiological Guidelines (COCIS) for Competitive Sport Eligibility in athletes with heart disease: update 2024

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Abstract

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Medical