ReviewAtrial Fibrillation in Athletes
Section snippets
Risk for AF in athletes
The incidence of AF in the general population is about 0.1% per year with a mean prevalence of 0.8 to 1% with older patients accounting for the greatest proportion of patients.1, 2 Reports from epidemiologic studies demonstrating AF in athletes have been variable on the basis of age, years of training, and associated co-morbidities. Furlanello et al6 reported that AF accounted up to 0.2% in a population of 5,000 athletes. Pelliccia et al7 reported that the prevalence of AF was 0.3% in a study
Pathophysiology of Atrial Fibrillation in Athletes
The mechanism of AF in athletes is multifactorial (Figure 1).
Clinical Features
AF in athletes is always abnormal and thorough investigation is mandatory. The AF associated with sports is usually paroxysmal with occasional crisis. Forty percent of athletes with Wolf-Parkinson-White syndrome or concealed atrioventricular bypass tracts show periods of AF.29 Arrhythmia can also manifest in hypertrophic cardiomyopathy or arrhythmogenic right ventricular cardiomyopathy.6 Diagnostic testing should include thyroid function tests, echocardiography in all patients and treadmill
Restriction from sports practices
The most important aspect of treatment in AF is recognizing cases as a manifestation of “overtraining syndrome.” In such cases, it may be prudent to interrupt sports training and control AF recurrence. Furlanello et al6 described a good response to sports abstinence in 1,772 top-level athletes with AF. However, there are few data that limitation of sports activities can have favorable outcomes in athletes with AF.
Pharmacotherapy
Beta blockers may not be of much use in athletes not only because they may reduce
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Heritability estimates of atrial fibrillation in Thoroughbred racehorses in Hong Kong and Australia
2021, Journal of Veterinary CardiologyExercise-Induced Arrhythmias
2018, Cardiac Electrophysiology: From Cell to Bedside: Seventh EditionAtrial Fibrillation in Athletes: A Lesson in the Virtue of Moderation
2017, JACC: Clinical ElectrophysiologyCitation Excerpt :Proposed mechanisms include alterations of autonomic tone, left atrial enlargement and fibrosis, electrical remodeling, and increased inflammation (30–47). Although these mechanisms are complex and likely vary among individuals, there is a growing consensus that common elements include autonomic, structural, and electrophysiological remodeling that predispose to triggered activity arising from the pulmonary veins or reentry within the atrial tissue (30–47). Clinical studies demonstrated that at rest and during low-intensity physical activity, endurance athletes have dominant vagal tone compared with nonathletes (30–32).
Atrial fibrillation in highly trained endurance athletes — Description of a syndrome
2017, International Journal of CardiologyCitation Excerpt :Direct-current cardioversion may be an option in younger athletes with disabling symptoms in the absence of structural heart disease [40]. Anticoagulation management is the same as in the general population [40]. Because autonomic hyperactivation is important in the initiation and maintenance of AF in athletes, direct-current cardioversion may not be a definitive treatment and there may be a high risk for recurrence [40].
Left atrial remodeling, early repolarization pattern, and inflammatory cytokines in professional soccer players
2016, Journal of CardiologyCitation Excerpt :As opposed to other causes of AF, lone AF is generally benign. However, results reporting mortality data in athletes with AF are scarce and inconsistent [11,12]. The mechanism of AF in athletes is multifactorial.
Risk Factors and Genetics of Atrial Fibrillation
2016, Heart Failure Clinics