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.................. 10. Supplementary data

Supplementary Data with additional Supplementary Figures, Tables, and text complementing the full text are available on the European Heart Journal website and via the ESC website at www.escardio.org/ guidelines. 11 Appendix

Author/Task Force Member Affiliations: Sabiha Gati, Faculty of Medicine, National Heart & Lung Institute, Imperial College, London, United Kingdom and Cardiology, Royal Brompton & Harefield Hospital NHS Foundation Trust, London, United Kingdom;

Vigorous exercise associated with a maximal predicted heart rate >90% of the predicted heart rate is not recommended during pregnancy. III B Exercising while lying supine on a hard surface is not recommended after the first trimester due to the risk of decreased venous return and uterine blood flow. III B Recommendations for exercise in chronic kidney disease Low- to moderate-intensity aerobic exercise training (up to 150 min/week), and low- to moderate-intensity resistance exercise training (2 day per week, 812 exercises, 1215 repetitions), and flexibility exercises are recommended in all individuals with CKD. I A Among patients with established osteodystrophy/osteoporosis, or coagulopathies, participation in contact sports is not recommended. III C Participation in sport is not recommended in the following circumstances: electrolyte abnormalities, recent changes to the ECG, excess inter-dialysis weight gain, changing or titration of medication regimen, pulmonary congestion, and increasing peripheral oedema. III C Recommendations for exercise in individuals with cancer Regular exercise during and after cancer therapy is recommended to reduce cancer-related fatigue, and improve quality of life, physical fitness, and prognosis. I A Among individuals treated with cardiotoxic medications, echocardiography before participation in high-intensity exercise is recommended. I A Recommendations for exercise in individuals with spinal cord injury In adults with spinal cord injury participation in 20 min of moderate- to vigorous-intensity aerobic exercise at least 3 times a week, along with moderate-intensity resistance training 23 times per week, is recommended for cardiorespiratory fitness, cardiometabolic health, and muscle strength benefits. I A Artificial methods of inducing autonomic dysreflexia by causing intentional pain to the lower half of the body (‘boosting’) through obstruction of an indwelling urinary catheter, overly tight leg straps and electrical shocks or other methods of pain to the genitalia or lower limbs can be life-threatening and are not recommended. III C Recommendations for exercise in individuals with ventricular assist devices Regular exercise, through cardiac rehabilitation, combining moderate-intensity aerobic and resistance exercise, is recommended in individuals with a ventricular assist device (VAD). I A Sports that may potentially affect any of the VAD components (e.g. with body contact) are not recommended. III C Physical activity and sports recommendations in patients and athletes with peripheral arterial disease It is recommended that patients with atherosclerotic PAD perform regular exercise (at least 150 min/week of moderate aerobic exercise or 75 min/week of vigorous aerobic exercise or a combination thereof) as part of the secondary prevention strategy. I A In patients with symptomatic LEAD, supervised exercise training programmes including walking to the maximal or submaximal distance for at least 3 h/week are indicated. I A Continuation of competitive sports is recommended in athletes with traumatic or non-traumatic PAD following recovery after successful open surgery or percutaneous revascularization. I C

ACM = arrhythmogenic cardiomyopathy; AF = atrial fibrillation; AOCA = anomalous origin of coronary arteries; BP = blood pressure; BMI = body mass index; BrS = Brugada syndrome; CAD = coronary artery disease; CCS = chronic coronary syndrome; CHD = congenital heart disease; CKD = chronic kidney disease; CMR, cardiovascular magnetic resonance; CT = computed tomography; CV = cardiovascular; CVD= cardiovascular disease; EEG = electrocardiogram; EP = electrophysiological; ESC = European Society of Cardiology; EP = electrophysiological; HF = heart failure; HFrEF = heart failure with reduced ejection fraction; ICD = implantable cardioverter defibrillator; LEAD = lower extremity artery disease; LQTS = long QT syndrome; LVEF = left ventricular ejection fraction; LVOT = left ventricular outflow tract; MVA = mitral valve area; NYHA = New York Heart Association; PAD = peripheral arterial disease; PVC = premature ventricular contractions; SCD = sudden cardiac death; SBP = systolic blood pressure; VA = ventricular arrhythmia; VAD = ventricular assist device; VT = ventricular tachycardia. aClass of recommendation. bLevel of evidence. Downloaded from academic.oup.com/eurheartj/article/42/1/17/5898937 by guest on 07 October 2026