Exercise as therapy in congenital heart disease — A gamification approach

•Exercise is underused as therapy in adults with congenital heart disease.•Regular exercise is potentially very effective in improving the lives of patient with congenital heart disease.•A gamification approach to exercise prescription has the potential to improve exercise uptake.

Despite considerable evidence of efficacy, exercise is an underused therapy in congenital heart patients. In this paper, the evidence that exercise is a beneficial treatment in patients with congenital heart disease is described. The potential mechanisms for benefit are investigated and contrasted with the potential risks of introducing an exercise prescription to children and adults with congenital heart disease. Finally, the challenges of exercise prescription are considered and a case is made for the use of gamification as a methodology for increasing adherence to an exercise prescription.