Lone atrial fibrillation in vigorously exercising middle aged men: case-control study

Karjalainen, Jouko; Kujala, Urho M.; Kaprio, Jaakko; Sarna, Seppo; Viitasalo, Matti

doi:10.1136/bmj.316.7147.1784

Cited by 280 publications

(220 citation statements)

References 5 publications

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“…Intensywne uprawianie sportu, zwłaszcza wytrzymałościowego (> 1500 h uprawiania sportów wytrzymałościowych) [899], zwiększa ryzyko AF w późniejszym okresie życia [900][901][902], co prawdopodobnie zależy od zmian napięcia układu autonomicznego, obciążenia objętościo-wego podczas wysiłku, przerostu przedsionka, a także jego powiększenia [903,904]. Prowadzi to do zależności między aktywnością fizyczną a zapadalnością na AF, która ma kształt krzywej U [214,898,902,905,906]. Zmniejszenie obciążeń treningowych może ograniczać występowanie AF w modelach [904] i zmniejsza komorowe zaburzenia rytmu u sportowców [907], ale rola takiego postępowania w odniesieniu do występowania AF u sportowców jest nieznana.…”

Section: Uprawianie Sportu a Migotanieunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,380

4,206

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Section: Uprawianie Sportu a Migotanieunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,380

4,206

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“…6,[8][9][10][11][12][13][14][15] Furlanello et al 16 and Pelliccia et al 17 reported a low rate of AF (0.2 % and 0.3 %, respectively), no different from that observed in the general population. However, both studies included exclusively young athletes with relatively fewer years of training.…”

Section: Prevalence and Incidence Of Atrial Fibrillation In Endurancementioning

confidence: 99%

“…Karjalainen and colleagues 8 were the first to establish a relationship between endurance sport practice and AF, reporting a 5.5 odds ratio for AF associated with vigorous exercise, in a series of middle-aged endurance cross-country runners. Elousa et al 12 showed analogous results, with three times higher prevalence of lone AF and five times higher prevalence of vagal AF, indicating a threshold limit of 1,500 lifetime hours of intense endurance practice in order to attain this association.…”

Section: Prevalence and Incidence Of Atrial Fibrillation In Endurancementioning

confidence: 99%

Endurance Sport Activity and Risk of Atrial Fibrillation – Epidemiology, Proposed Mechanisms and Management

Fragakis

Vicedomini

Pappone

2011

Arrhythmia &Amp; Electrophysiology Review

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Although atrial fibrillation (AF) is considered the most common arrhythmia in clinical practice, its prevalence is relatively low in the young and middle-aged, ranging from 0.5 % in men below 40 years to 1 % by 60 years.1,2 Regular exercise is proposed as a powerful tool for the primary and secondary prevention of cardiovascular disease, reducing most of the risk factors that predispose to AF, such as hypertension, diabetes mellitus, coronary artery disease and obesity.3,4 However, there is growing evidence that long-term endurance exercise may increase the risk of developing AF, with a reported 2-10 times greater prevalence in athletes and those who are involved in long-term sport participation. 5Why athletes should be susceptible to AF is an issue of ongoing debate. Several mechanisms underlying the association between exercise and AF have been proposed but they remain speculative.It is of interest that adaptations such as sinus bradycardia and atrioventricular node disturbances, which are generally considered benign and reversible after a short period of detraining, have been considered by some investigators as a reason for AF development in elderly athletes. 6 It is clear that AF in athletes has some differences in cause, clinical presentation and treatment strategies compared with the general population. The aim of this short review is to present the existing data about the epidemiology of AF in athletes and those engaged in long-term endurance sport practice, to analyse the pathophysiological mechanisms that connect AF with exercise, and finally to discuss the existing treatment options. Prevalence and Incidence of Atrial Fibrillation in Endurance Sport Practice and in Vigorous Physical ActivityThe prevalence of AF in the athletic community varies considerably dependent on the age and the number of years of training of the subjects. It is essential to make a distinction between studies including young athletes with only a few years of training and those with middle-aged or older individuals practising sports for many years.Whereas the incidence of AF in young athletes appears similar to that observed in the general population, in older athletes an increased incidence of AF is reported. 6,[8][9][10][11][12][13][14][15] Furlanello et al. 16 and Pelliccia et al. 17 reported a low rate of AF (0.2 % and 0.3 %, respectively), no different from that observed in the general population. However, both studies included exclusively young athletes with relatively fewer years of training. In contrast, several other studies of middle-aged athletes, who were engaged in sport training for many years, demonstrated an increased prevalence of AF compared with the rest of the population (see Table 1). A common characteristic among all these studies was that the participating athletes were predominately male and they were involved in endurance sports. The prevailing pattern of AF was the so-called vagal lone AF, as it was usually encountered in relatively young individuals (<60 years old) without clinical or echocardiographic e...

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“…A tartós, intenzív fi zikai tréning növeli a fl utter és a PF előfordulását, amit a vagustonus-fokozódás, a bradycardia, a hirtelen katecholamin-emelkedések, az emocionális stressz magyaráz [8,9,10,11,12].…”

Section: Gyakori a Pitvarfi Brilláció A Sportolóknálunclassified

Atrial fibrillation and physical activity

Apor

2013

Orvosi Hetilap

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Elsősorban a tartós és intenzív állóképességi sportokban, a futásban rendszeres edzést végzők körében tapasztalnak az átlagnépességhez képest gyakrabban izolált pitvarfi brillációt. A sokféle hajlamosító tényező közül a sportolókon a fokozott vagustonus mellett hirtelen szimpatikus impulzusok, az ismételt oxidatív stressz és a gyulladásos markerszint emelkedései, a pitvar adaptív tágulása, elektromos instabilitás, a versenyzéssel járó emocionális stressz okolhatók. Idősebbeken, veterán sportolókon természetesen cardiovascularis eltérések is előtérbe kerülnek. Heti három-öt órányi testmozgás számos egyéb pozitív egészségi előnye miatt a (korábban) pitvarfi brilláló személyeknek is javasolt, ez nem növeli a pitvarfi brillációval járó kockázatot. Az antiaritmiás szerek és az ablatio alkalmazásának jelenleg nincs sportspe cifi kuma, a törekvés a biztonságosság mellett a (verseny)sportolásban megmaradás. Orv. Hetil., 2013, 154, 503-509. Kulcsszavak: pitvarfi brilláció, sportolók, veterán sportolók, epidemiológia, hajlamosító tényezők, fi zikai aktivitás Atrial fi brillation and physical activityAtrial fi brillation is the most frequent arrhythmia. Its "lone" form (when underlying pathology is not discovered) can be detected in a few percent of endurance sports participants, and in growing occurrence among the veterans, probably on the basis of some cardiac or other irregularities. Enhanced vagal tone and sudden sympathetic impulse, repetitive oxidative stress, infl ammatory processes, enlarged atria, electric instabilization can explain the higher occurrence. Treatment of atrial fi brillation enables the affected persons to participate in regular medium-intensity exercise, 3-5 hours a week, which offers a protective role against cardiovascular, metabolic and mental illnesses. Orv. Hetil., 2013, 154, 503-509. Keywords: atrial fi brillation, sportsmen and masters, epidemiology, predisposing factors, physical activity (Beérkezett: 2013. január 2.; elfogadva: 2013. február 12.) Rövidítések COPD = krónikus obstruktív tüdőbetegség; hsCRP = nagy ér-zékenységű C-reaktív protein; PF = pitvarfi brilláció; Pro-ANP = pronatriureticus hormon; WPW = Wolff-Parkinson-Whiteszindróma Korunkban jelentősen sokasodik a pitvari fi brillációval (PF) élők száma. Akár cardiovascularis eltérésekhez csatlakozik, akár izolált (lone) a ritmuszavar, a betegnek élet-vitelromlást okoz, emellett a hirtelen szívhalál és a stroke fokozott veszélyével jár.A fél évszázada terjedő coronariahalálozási járvány megfékezésében a rendszeres fi zikai aktivitás szorgalmazása, az aerobik sokoldalú haszna ezerszeresen igazolást nyert. A csak a fi zikai aktivitással megszerezhető jobb fi ttség védőhatást ad nemcsak a cardiovascularis betegségek fellépése ellen, hanem a cukoranyagcsere-zavar, a dyslipidaemia, a hypertonia, a veseelégtelenség, egyes rákféleségek 20-40%-kal ritkábban lépnek fel az aktí-vakon, a praehypertonia, a praediabetes nem vagy lassabban fordul betegségbe [1]. A jobb fi ttség (nagyobb maximális oxigénfelvevő képesség = nagyobb aerob kapac...

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Lone atrial fibrillation in vigorously exercising middle aged men: case-control study

Cited by 280 publications

References 5 publications

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Endurance Sport Activity and Risk of Atrial Fibrillation – Epidemiology, Proposed Mechanisms and Management

Atrial fibrillation and physical activity

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