BackgroundThe relationship between competitive sports and atrial fibrillation (AF) is controversial. We aimed to systematically evaluate and summarize all published observational data on the association between competitive sports and AF.Methods and resultsWe searched PubMed, EMBASE, Scopus and SportDiskus for all observational studies that assessed the risk of AF among athletes involved in competitive sports. Data were extracted and pooled odds ratios (OR) were calculated using random effects models. Six cohort studies and 2 case-control studies with a total of 9113 subjects were included in our meta-analysis. Pooled analyses showed an increased risk of incident and prevalent AF among athletes compared to the general population (OR = 1.64 [95% confidence interval (CI): 1.10–2.43]). Age-stratified analysis revealed an effect modification with age. Studies enrolling younger adults (<54 years) had an increased risk of AF among athletes compared to controls (OR = 1.96 [95% CI: 1.06–3.65]), but this association was not seen among older adults ≥54 years (OR = 1.41 [95% CI: 0.81–2.44], p = 0.23).ConclusionAthletes have an increased risk of AF compared to the general population. Age appears to modify the risk of AF in athletes.

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Background. A previous study found that the electrophysiological response to ischemia is altered in hypertrophic myocardium, resulting in prolonged transmural activation time (TAT) associated with induction of sustained monomorphic ventricular tachycardia. This study investigated the role of hemodynamics in modulating TAT and the cycle length of induced ventricular tachycardia (VT) in dogs with left ventricular hypertrophy (LVH).Methods and Resuts. Anesthetized open-chest dogs underwent 3 hours of uninterrupted circumflex coronary occlusion. During atrial drive, TAT was recorded between endocardial and epicardial bipolar pairs on the same multipolar plunge needle placed in nonischemic and ischemic zones, documented by triphenyltetrazolium chloride staining. TAT and VT induced by up to three extrastimuli were studied during hypertension (control), during normotension produced most frequently by nitroprusside infusion (3-6 ag/kg/min), and during further hypertension most frequently produced by phenylephrine infusion (1-5 jLg/kg/min). Twenty-five dogs with chronic hypertension and LVH (group 1) produced by a

Although fairly common, syncope is a frightening symptom that can signal a serious underlying disease. The varying causes present a diagnostic challenge to the examining physician, who needs to assess whether referral for more specialized or invasive study is appropriate. The authors review common cases of syncope and outline a practical approach to rapidly identifying high-risk patients--in other words, to separating the "wheat" from the "chaff."