Decades of risk-averse guidance have left children with cardiomyopathy sedentary, with poor cardiorespiratory fitness and added cardiometabolic risk. This AHA Scientific Statement provides an evidence-based framework to actively promote physical activity in paediatric hypertrophic, dilated, restrictive and arrhythmogenic cardiomyopathy. Newer data suggest sudden cardiac death risk in selected patients is not higher with exercise than with inactivity, and physical activity may even support reverse remodelling. The statement offers a practical framework for risk stratification and personalised exercise prescription.
Physical activity (PA) is essential for the cardiovascular, emotional, and social health of all children and adolescents. However, for pediatric patients with cardiomyopathy, decades of risk-averse clinical guidance have resulted in widespread PA restriction due to fears of sudden cardiac death and disease progression. This has contributed to sedentary behavior, poor cardiorespiratory fitness, and increased risk of secondary cardiometabolic conditions in this population. However, emerging data challenge this restrictive paradigm, showing that the risk of sudden cardiac death may not be higher in some patients with cardiomyopathy who exercise than in those who are less active, and that participation in PA may also have a positive effect on reverse remodeling. This American Heart Association scientific statement provides an evidence-based framework for the promotion of PA in pediatric patients with hypertrophic cardiomyopathy, dilated cardiomyopathy, restrictive cardiomyopathy, or arrhyt
