Arrhythmogenic Activity During Exercise in ARVC Patients

March 19, 2026 updated by: Swiss Federal Institute of Technology

Characterization of Arrhythmogenic Activity During and After Physical Exercise in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)

Current guidelines advocate that ARVC patients, typically young and active individuals with a significant history of competitive endurance sports, cease endurance training in favour of activities with low cardiac burden such as bowling and golf. Empirically, it is often suggested that heart rate during exercise should not exceed 100-120 bpm in these patients, but these guidelines are arbitrary and not scientifically based. In practice, it is estimated that up to 50% of patients do not comply with these recommendations .

Adequate quantification of the arrhythmogenic burden, defined as premature ventricular beats in proportion to all heart beats in each period of time, and cardiac load (defined as stroke volume for volume load and systolic blood pressure for pressure load) experienced by ARVC patients when performing different types of physical exercise would be a first step towards designing a safe and effective intervention so that these patients can profit from an active life style.

This study therefore aims to quantify and describe the arrhythmogenic burden and cardiac load experienced by patients with ARVC while performing different physical exercise over a range of intensities - all strictly within the range currently recommended by different cardiological societies.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

In this study, ARVC patients with different genotypes will perform a series of different physical activities, including treadmill walking, cycling at different intensities, biceps curls and loaded squats while undergoing extensive cardiovascular monitoring.

Study Type

Interventional

Enrollment (Estimated)

120

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Christina M Spengler, PhD, MD
  • Phone Number: +41446325007
  • Email: spengler@ethz.ch

Study Locations

    • Canton of Zurich
      • Zurich, Canton of Zurich, Switzerland, 8092
        • Recruiting
        • Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Definitive ARVC diagnosis according to the modified 2010 ARVC Task Force Criteria
  • Pathogenic / likely pathogenic variant in one of the following desmosomal genes: plakophilin-2 (PKP-2), desmoglein-2 (DSG-2) or desmoplakin (DSP) or gene-elusive definite ARVC (i.e., genetic test performed but no pathogenic / likely pathogenic variant found)
  • Control group: diagnosed ischemic heart disease with ejection fraction above 35%
  • Agreement with responsible primary cardiologist that study participation is not considered beyond acceptable levels of physical activity for this particular patient
  • No history of exercise-induced syncope in the 6 months prior to study participation
  • No history of sudden cardiac arrest in the 6 months prior to study participation
  • In patients who suffered from sudden cardiac arrest/arrhythmic syncope, only those having an implantable cardioverter-defibrillator (ICD) and being under beta-blockers/antiarrhythmic drugs are eligible for study inclusion
  • Informed Consent as documented by signature (Appendix Informed Consent Form)
  • Age: > 14 years
  • Body-Mass-Index (BMI): 18.5 - 39.9 kg・m-2
  • Willing to adhere to the following study rules:

    • No intense exercise 48h prior to testing
    • No exercise 24h prior to testing
    • Sleep at least 7h the two nights before testing On test day
    • No caffeinated food or drink before testing on test day
    • No alcohol before testing on test day
    • Fully compliant with normal medication regimen including beta-blockers and antiarrhythmic medication

Exclusion Criteria:

  • No genetic test history for ARVC variants
  • Heart failure with severely reduced left ventricular ejection fraction (LVEF <35%)
  • For women: Pregnancy, breastfeeding, or intention to become pregnant during the study.
  • Known or suspected non-compliance, drug, or alcohol abuse
  • Inability to follow the procedures of the study, e.g., due to language problems, psychological disorders, dementia, etc. of the participant
  • Previous enrolment into the current study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Patients Group
All patients will perform all exercises. Arrhythmogenic activity will compared with that assessed during treadmill walking.
Participants will perform 3 min of the different activities, followed by a 10-min recovery window.
Other Names:
  • cycling, squats, biceps curls, walking

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
count of premature ventricular beats during and after the activities
Time Frame: measured during the 3 min of activity and the 10 min of recovery
count of premature ventricular beats during and after the activities
measured during the 3 min of activity and the 10 min of recovery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
cardiac load during different activities, as rate-pressure product
Time Frame: measured during the 3 min of activity
product of heart rate and systolic blood pressure
measured during the 3 min of activity
cardiac load during different activities, as cardiac output
Time Frame: measured during the 3 min of activity
product of heart rate and stroke volume, in L/min
measured during the 3 min of activity
cardiac load during different activities, as peak blood pressure
Time Frame: measured during the 3 min of activity
systolic blood pressure, in mmHg
measured during the 3 min of activity

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Christina M Spengler, PhD, MD, ETH Zurich, Exercise Physiology Lab, Institute of Human Movement Sciences and Sport

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 1, 2023

Primary Completion (Estimated)

December 31, 2027

Study Completion (Estimated)

December 31, 2027

Study Registration Dates

First Submitted

September 8, 2023

First Submitted That Met QC Criteria

September 8, 2023

First Posted (Actual)

September 15, 2023

Study Record Updates

Last Update Posted (Actual)

March 24, 2026

Last Update Submitted That Met QC Criteria

March 19, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • EAP_2020

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.