Does High-Intensity Endurance Training Increase the Risk of Atrial Fibrillation?

Opondo, Mildred; Aiad, Norman; Cain, Michael T.; Sarma, Satyam; Howden, Erin J.; Stoller, Douglas; Ng, Jason; Rijckevorsel, Pieter van; Hieda, Michinari; Tarumi, Takashi; Palmer, M. Dean; Levine, Benjamin D.

doi:10.1161/circep.117.005598

Cited by 32 publications

(29 citation statements)

References 51 publications

(59 reference statements)

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“…It is worth noting that exercise might not be recommended for individuals with mutations that cause atrial fibrillation and cardiomyopathy. Furthermore, intense endurance exercise appears to increase LA size in elite or recreational athletes and may subsequently predispose to AF (Iskandar et al, 2015; Elliott et al, 2018; Opondo et al, 2018). This is a dose-responsive effect that increases with lifetime hours of participation in endurance athletic activity (Flannery et al, 2017).…”

Section: Weight Loss and Exercise In Af Risk Reductionmentioning

confidence: 99%

Clinical Overview of Obesity and Diabetes Mellitus as Risk Factors for Atrial Fibrillation and Sudden Cardiac Death

et al. 2019

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The epidemics of obesity and diabetes mellitus are associated with an increased incidence of both atrial fibrillation (AF), the most common sustained arrhythmia in adults, and sudden cardiac death (SCD). Obesity and DM are known to have adverse effects on cardiac structure and function. The pathologic mechanisms are thought to involve cardiac tissue remodeling, metabolic dysregulation, inflammation, and oxidative stress. Clinical data suggest that left atrial size, epicardial fat pad thickness, and other modifiable risk factors such as hypertension, glycemic control, and obstructive sleep apnea may mediate the association with AF. Data from human atrial tissue biopsies demonstrate alterations in atrial lipid content and evidence of mitochondrial dysfunction. With respect to ventricular arrhythmias, abnormalities such as long QT syndrome, frequent premature ventricular contractions, and left ventricular hypertrophy with diastolic dysfunction are commonly observed in obese and diabetic humans. The increased risk of SCD in this population may also be related to excessive cardiac lipid deposition and insulin resistance. While nutritional interventions have had limited success, perhaps due to poor long-term compliance, weight loss and improved cardiorespiratory fitness may reduce the frequency and severity of AF.

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Section: Weight Loss and Exercise In Af Risk Reductionmentioning

confidence: 99%

Clinical Overview of Obesity and Diabetes Mellitus as Risk Factors for Atrial Fibrillation and Sudden Cardiac Death

et al. 2019

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“…A revisão da literatura resultou em 22 artigos, os quais foram classificados de acordo com o tipo de publicação: 8 coortes, 9,10,11,12,13,14,15,16 5 Ensaios clínicos, 17,18,19,20,29 3 Estudos caso-controle 21,22,23 e 6 Estudos observacionais. 24,25,26,27,28,30 .…”

Section: Resultsunclassified

“…Ainda que um estudo apontou indivíduos com FA onde, na presença de exercícios físicos, a qualidade de vida deles aumentou, 18 em 12 estudos realizados com atletas profissionais ou de alto desempenho mostraram que esse tipo de exercício traz consequências arritmogênicas, favorecendo a FA, ou a remodelação atrial esquerda ou direita. 11,13,14,15,17,19,22,23,24,25,27,30 Além disso, o estudo de Reinhardt et al, detalha ainda, que, em atletas, ocorre com maior prevalência uma repolarização atrial do tipo precoce, aliados a uma frequência cardíaca (FC) menor. 12 Considerando essa análise da diminuição da frequência, Grundvold I, foi capaz de relacioná-la ao desenvolvimento de FA ao observar que homens saudáveis de meia idade, quando possuem uma FC menor que 100 bpm, têm um risco maior para surgimento de FA.…”

Section: Resultsunclassified

Fibrilação Atrial Em Atletas

Almeida¹,

Barroso²,

Ferreira³

et al. 2021

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Objetivos: Embasar na literatura a correlação existente na prática de exercícios físicos de alta potência praticadas por atletas e a incidência de fibrilação atrial. Métodos: Revisão integrativa com artigos selecionados nas bases de dados Pubmed, Scielo, Medline e Lilacs publicados entre os anos de 2011 e 2021, com ensaios e estudos clínicos, além de estudos observacionais. Os descritores utilizados foram: (athletes) AND (atrial fibrillation). Resultados: Alguns estudos apontaram uma baixa incidência de fibrilação atrial entre atletas de elite. Enquanto outros constataram que o treinamento de alta intensidade de atletas competitivos está relacionado a um maior risco de fibrilação atrial, principalmente homens saudáveis de meia idade, quando possuem uma frequência cardíaca menor que 100 bpm. Considerações finais: A Fibrilação atrial em atletas tem uma incidência maior em atletas do sexo masculino e mais velhos que realizam treinos de alta intensidade, visto que possuem como potenciais indutores o remodelamento cardíaco, a inflamação e a fibrose.

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Section: Introductionmentioning

confidence: 99%

“…33 The importance of substantial lifetime exposure to high-intensity endurance exercise has also been illustrated in a 2018 paper by Opondo et al reporting that 10 months of dedicated high-intensity exercise training induces changes in left atrial structure and mechanical function but without electrical consequences in middleaged adults. 34 Another potential exercise-related cardiac detriment is myocardial fibrosis (MF). A body of research has reported a heterogeneous profile of myocardial scarring in endurance athletes concerning prevalence, location, extent, aetiology and clinical significance.…”

Section: Introductionmentioning

confidence: 99%

Endurance exercise and the risk of cardiovascular pathology in men: a comparison between lifelong and late-onset endurance training and a non-athletic lifestyle - rationale and design of the Master@Heart study, a prospective cohort trial

Bosscher

Dausin

Claus

et al. 2021

BMJ Open Sport Exerc Med

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IntroductionLow and moderate endurance exercise is associated with better control of cardiovascular risk factors, a decreased risk of coronary artery disease and atrial fibrillation (AF). There is, however, a growing proportion of individuals regularly performing strenuous and prolonged endurance exercise in which the health benefits have been challenged. Higher doses of endurance exercise have been associated with a greater coronary atherosclerotic plaque burden, risk of AF and myocardial fibrosis (MF).Methods and analysisMaster@Heart is a multicentre prospective cohort study aiming to assess the incidence of coronary atherosclerosis, AF and MF in lifelong endurance athletes compared to late-onset endurance athletes (initiation of regular endurance exercise after the age of 30 years) and healthy non-athletes.The primary endpoint is the incidence of mixed coronary plaques. Secondary endpoints include coronary calcium scores, coronary stenosis >50%, the prevalence of calcified and soft plaques and AF and MF presence. Tertiary endpoints include ventricular arrhythmias, left and right ventricular function at rest and during exercise, arterial stiffness and carotid artery intima media thickness.Two hundred male lifelong athletes, 200 late-onset athletes and 200 healthy non-athletes aged 45–70 will undergo comprehensive cardiovascular phenotyping using CT, coronary angiography, echocardiography, cardiac MRI, 12-lead ECG, exercise ECG and 24-hour Holter monitoring at baseline. Follow-up will include online tracking of sports activities, telephone calls to assess clinical events and a 7-day ECG recording after 1 year.Ethics and disseminationLocal ethics committees approved the Master@Heart study. The trial was launched on 18 October 2018, recruitment is complete and inclusions are ongoing.Trial registration numberNCT03711539.

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Does High-Intensity Endurance Training Increase the Risk of Atrial Fibrillation?

Abstract: URL: https://www.clinicaltrials.gov. Unique Identifier: NCT02039154.

Cited by 32 publications

References 51 publications

Clinical Overview of Obesity and Diabetes Mellitus as Risk Factors for Atrial Fibrillation and Sudden Cardiac Death

Clinical Overview of Obesity and Diabetes Mellitus as Risk Factors for Atrial Fibrillation and Sudden Cardiac Death

Fibrilação Atrial Em Atletas

Endurance exercise and the risk of cardiovascular pathology in men: a comparison between lifelong and late-onset endurance training and a non-athletic lifestyle - rationale and design of the Master@Heart study, a prospective cohort trial

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