State of the Art Review: Atrial Fibrillation in Athletes

Flannery, D.; Kalman, Jonathan M.; Sanders, Prashanthan; Gerche, André La

doi:10.1016/j.hlc.2017.05.132

Cited by 74 publications

(43 citation statements)

References 66 publications

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“…Recent evidence shows that a non-sedentary lifestyle activity plays a protective factor with regard to AF occurrence; however, extreme and prolonged exercise itself can be considered a risk factor for AF [71,72]. In the majority of population-based studies, mild to moderate physical activity was associated with a decreased AF risk, whereas only few studies failed to show an association between exercise and AF [73,74]. It has been suggested that daily walking or cycling might lead to a risk reduction of AF by about 20% [75].…”

Section: Physical Activitymentioning

confidence: 99%

Atrial fibrillation: A review of modifiable risk factors and preventive strategies

Shamloo

Dagres

Arya

et al. 2019

Romanian Journal of Internal Medicine

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Atrial fibrillation (AF), as the most common cardiac arrhythmia worldwide, is associated with increased mortality and morbidity. Successful therapeutic strategies have been introduced so far, but they are associated with significant costs. Therefore, identification of modifiable risk factors of AF and the development of appropriate preventive strategies may play a substantial role in promoting community health and reducing health care system costs. Modifiable cardiovascular risk factors including obesity, hypertension, diabetes mellitus, obstructive sleep apnea, alcohol consumption, smoking, and sedentary lifestyles have been proposed as possible contributors to the development and progression of AF. In this review, we discuss the role of modifiable risk factors in the development and management of AF and the evidence for the underlying mechanism for each of the potential risk factor.

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Section: Physical Activitymentioning

confidence: 99%

Atrial fibrillation: A review of modifiable risk factors and preventive strategies

Shamloo

Dagres

Arya

et al. 2019

Romanian Journal of Internal Medicine

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“…Genetic factors may also play a role in the development of AF. Genome wide association studies have identified a number of single nucleotide polymorphisms in various genes associated with increased risk of developing AF in non-athletes [40]. However, the role of exercise in amplifying or reducing the risk of AF with these genetic polymorphisms remains untested [41].…”

Section: Mechanisms and Pathophysiology Of Atrial Fibrillation In Athmentioning

confidence: 99%

“…metoprolol) or calcium-channel blockers (e.g. verapamil) is useful in preventing 1:1 atrial flutter secondary to flecainide [40].…”

Section: Treatment Of Atrial Fibrillation In Athletesmentioning

confidence: 99%

“…Amiodarone is a valid alternative to flecainide. However, its use should be limited to the acute phase due to the well known side effects related to its chronic use [40].…”

Section: Treatment Of Atrial Fibrillation In Athletesmentioning

confidence: 99%

“…However, athletes usually prefer not to take regular medications. Furthermore, beta-blockers reduce exercise tolerance and they can be poorly tolerated [40] because of their negative chronotropic effect which is disadvantageous in subjects with a slow heart rate per se. Finally beta-blockers are usually included among doping drugs and their use may be responsible for disqualification from competitions [49].…”

Section: Treatment Of Atrial Fibrillation In Athletesmentioning

confidence: 99%

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Atrial fibrillation in athletes: From epidemiology to treatment in the novel oral anticoagulants era

Sanna

Gabrielli

Vito

et al. 2018

Journal of Cardiology

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It has been documented that physical activity may increase the risk of atrial fibrillation (AF) in active or former competitive athletes. Different mechanisms are involved and responsible for the development of the arrhythmia, such as structural changes of the left atrium, influences of autonomic nervous system with enhanced vagal tone, and the use of prohibited substances with arrhythmogenic effects. Difficulties in the management of AF in athletes may derive from the low compliance to antiarrhythmic therapy and the selection of the most appropriate strategy for thromboembolic risk prevention. In fact, the majority of athletes are young, healthy, without any particular risk factor, except for arterial hypertension which can be the only risk factor in the evaluation of antithrombotic therapy with the CHADS-VASc score. The integration of actual score with serum biomarkers and other clinical factors may be useful to identify patients who will benefit the most from anticoagulation. Nowadays the non-vitamin K antagonist oral anticoagulants (NOACs) may represent a valid alternative to vitamin K antagonists (VKA) in the prevention of ischemic stroke due to AF with a better safety profile.

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Longitudinal cardiac remodeling in collegiate American football players as assessed by echocardiography during their collegiate career

Hamburger,

Taha,

Ruzieh

et al. 2023

Clinical Cardiology

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BackgroundStudies on the longitudinal effects of intense physical training on cardiac remodeling are limited, especially in American collegiate football players.HypothesisCollege‐level American football training will result in remodeling in a pattern consistent of a sport with moderate static and dynamic demands with increases in both wall and chamber sizes.MethodsWe studied 85 American collegiate football players who underwent transthoracic echocardiogram (TTE) for asymptomatic or mild COVID‐19‐related illness and compared the changes in echo dimensions to their preparticipation screening TTE. Pre‐ and posttraining variables were compared using a paired t‐test for normally distributed variables.ResultsMean age was 19 years ± 1 and 61% of athletes were Black. Mean follow‐up between TTEs was 21 ± 13 months. There was an increase in left atrial volume index (26.4 ± 5.5 to 32.8 ± 8.4 mL/m2, p < .001), LV end diastolic diameter (5.13 ± 0.4 to 5.27 ± 0.4 cm, p = .003), basal RV diameter (3.28 ± 0.7 to 3.83 ± 0.5 cm, p = <.001), LV mass index (86.7 ± 15.3 to 90.1 ± 15.3, p = .015), and aortic root diameter (3.1 ± 0.4 to 3.2 ± 0.3 cm, p = .03) from pre‐ to posttraining, with a slightly greater magnitude in athletes with >2 years of training. Presence of left atrial enlargement (≥35 mL/m2) increased from 2.9% to 29% pre‐ to postparticipation in athletes with >2 years training. No significant changes in wall thickness, diastolic function, or right ventricular systolic function were observed.ConclusionAmerican football players college‐level training was associated with increases in left and right ventricular chamber sizes, left atrial size, and aortic root diameter.

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State of the Art Review: Atrial Fibrillation in Athletes

Cited by 74 publications

References 66 publications

Atrial fibrillation: A review of modifiable risk factors and preventive strategies

Atrial fibrillation: A review of modifiable risk factors and preventive strategies

Atrial fibrillation in athletes: From epidemiology to treatment in the novel oral anticoagulants era

Longitudinal cardiac remodeling in collegiate American football players as assessed by echocardiography during their collegiate career

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