In a moment that is immortalized on YouTube, 22-year-old Anthony Van Loo, a defender on the Belgian soccer team SV Roeselare, collapses to the pitch like a rag doll, his heart suddenly in a lethal rhythm. Seconds later Van Loo jerks violently, then sits upright, as if something has yanked him from death's door. Something had. Van Loo was saved by his implantable cardioverter defibrillator, or ICD. The matchbox-sized device can be surgically implanted in the chest of a person with a potentially deadly heart condition. There it stands guard, waiting to shock the heart back into a normal rhythm if the muscle goes haywire.
Van Loo was lucky. At least once every three days, an athlete in America will die when the mix of vigorous activity and an underlying heart condition leaves him or her in cardiac arrest. Among the victims have been basketball players Hank Gathers in 1990 and Reggie Lewis in '93, and Gaines Adams, the 26-year-old Bears defensive end who died two weeks ago. Such fatalities focus attention on whether athletes with confirmed heart problems should take precautions, even to the extent of getting an ICD. So far, no professional baseball, basketball or football player has competed with an ICD, but a number of college athletes have.
According to Martin Maron, a cardiologist at the Tufts Medical Center, ICDs are not made to withstand vigorous exercise or contact sports, and a shock during a competition could cause injury. But no hard data exist on what happens to people with ICDs who choose, with or without their doctor's permission, to participate in competitive sports. That's why Rachel Lampert, associate professor in cardiology at Yale, and her colleagues started a registry in 2007 to track competitive athletes with ICDs for four years. The registry currently has 241 athletes (ages 10 to 60) enrolled, 111 of whom play contact sports.
The issue of whether ICD-implanted athletes can participate in sports is particularly thorny. Last week Jesse DeSanto, one of the participants in the Yale study and a freshman second baseman at Guilford College in Greensboro, N.C., was granted the right to play after a doctor at the college initially barred him from the field. DeSanto agreed to sign a waiver absolving Guilford of liability and to monitor his ICD constantly. "I wouldn't play if I thought it was going to cost me my life," DeSanto says. "But I want to do something I love."
Lampert says that the registry, which can be contacted at icdsports.org, needs another 140 athletes to provide a meaningful statistical sample. "The registry doesn't recommend that people with ICDs go and play sports," Lampert adds. "But if they [do], the data could really help people and physicians make decisions."