Elite-level athletes who return to competitive sport after being diagnosed with a genetic heart disease have a low risk of cardiac events, show results from a first-of-its-kind study.

Just three out of 76 athletes in the cohort had non-fatal breakthrough cardiac events after return to play — a finding US cardiologists say challenges the historically “paternalistic” approach of disqualifying or restricting play for those with genetic heart diseases.

Their retrospective study tracked outcomes among 50 college and 26 professional athletes (mean age 19) with a genetic heart disease predisposing them to sudden cardiac death.

About three quarters of the patients were male and the most common diagnoses were hypertrophic cardiomyopathy (53%) and long QT syndrome (26%).