While competitive sports used to be frowned upon in the HCM literature, there is now some evidence that a patient’s risk from exercise is low when they have been implanted with an implantable cardioverter defibrillator (ICD). This feature from Medpage Today gives an overview of contemporary thinking about exercise in HCM patients.
Comprehensive risk assessment, combined with shared decision making around the decision to participate in sports, seems to be the way of the future. This is more fully discussed in the most recent ACC/AHA Guidelines.
However, ICDs should only be implanted if the patient is clearly at risk of sudden cardiac arrest; they should not be implanted solely for the purpose of allowing a low risk patient to participate in sports.