Abstract
BACKGROUND: Sudden cardiac death in infants is rare and is often linked to early-onset arrhythmogenic syndromes; unclear causes can lead to overly restrictive behavior owing to fear of recurrence. CASE SUMMARY: We report an 8-month-old male infant who survived a cardiac arrest due to ventricular fibrillation and who was treated with beta-blockers, sympathetic denervation, ablation, loop recorder, and implantable cardioverter-defibrillator. Genetic testing revealed multiple ambiguous variants. Six years of remote monitoring showed no arrhythmia recurrence. Multidisciplinary care enabled gradual, safe reintroduction of moderate physical activity. DISCUSSION: This case underscores the pivotal role of periodic reassessment and personalized management in pediatric cardiac arrest survivors, even in cases where genetic findings are inconclusive. CONCLUSIONS: The identification and treatment of arrhythmic focus, as well as cardiac monitoring, the use of devices for secondary prevention, and shared decision-making support, ensured a safe and selective return to sports. TAKE-HOME MESSAGE: Multidisciplinary care and periodic reassessment support individualized risk stratification and management to facilitate safe sports.