Patients with arrhythmogenic right ventricular cardiomyopathy have a significantly increased risk of SCD during exertion.S7.3-16,S7.3-17,S7.3-20,S7.3-21 Vigorous exercise in patients with arrhythmogenic right ventricular cardiomyopathy has been shown to impair myocardial function by echocardiogra- phy and cardiac MRI.S7.3-19 Participation in high intensity/duration or endurance physical activity accelerates the penetrance/disease progression and arrhythmic risk for arrhythmogenic right ventricular cardiomyopathy patients and muta- tion positive individuals, as well as mutation positive family members.S7.3-17,S7.3-19 S7.3-21 Patients with arrhythmogenic right ventricular cardiomy- opathy who participate in competitive sports are at increased risk for VT or SCD, compared with those who participate in recreational sports or Exercise influences disease progression in a linear manner; family members who limited activity to less than the AHA recommended minimum for activity guide- lines (<650 metabolic equivalent hours per year [MET-Hr/year]) were less likely to develop VA or In a study of arrhyth- mogenic right ventricular cardiomyopathy pro- bands and exercise, athletes (defined as subjects with 4h vigorous exercise/week) were found to have reduced biventricular function compared with nonathletes in arrhythmogenic right ven- tricular cardiomyopathy patients and in muta- tion-positive family members.S7.3-19 Many advise limiting exercise intensity and duration to <650 6. The proband with arrhythmogenic right ven- tricular cardiomyopathy is usually diagnosed by the presence of clinical symptoms along with the presence of arrhythmogenic right ventricu- lar cardiomyopathy Task Force criteria including: abnormalities on ECG, structural and functional changes of either ventricle, arrhythmias, and arrhythmogenic right ventricular cardiomyopathy in first-degree relatives.S7.3-6 A pathogenic genetic mutation was added to the major Task Force criteria in 2010.S7.3-44 The yield of genetic test- ing in probands with suspected arrhythmogenic right ventricular cardiomyopathy is generally 30% to 54%, and is up to 58% among patients with a strong family history of SCD in multiple A negative genetic test for arrhythmogenic right ventricular cardiomyop- athy does not exclude the disease, and a positive genetic test currently does not guide therapy.S7.3-22 For the proband with a clinical diagnosis of arrhythmogenic right ventricular cardiomyopathy, identification of pathogenic mutations provides limited prognostic information relative to the risk or development of HF.S7.3-22 In a large multicenter study, the presence of posi- tive mutations among probands was not asso- ciated with a difference in mortality or cardiac CLINICAL STATEMENTS AND GUIDELINES However, the identification of a pathogenic mutation facilitates targeted genetic screening for that mutation in first- degree relatives, that may identify approximately highest among siblings, and those with symptoms.S7.3-4 Screening for the specific mutation can identify some gene positive family members prior to disease expres- sion, while relieving others from the need for life- style changes and long-term monitoring.S7.3-2,S7.3-3 7. 