Long-lasting sport practice and lone atrial fibrillation

Abstract

Long-term vigorous exercise may predispose to atrial fibrillation.

Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise

“…29,31,54 Indeed, long-term sustained vigorous aerobic ET such as marathon or ultramarathon running or professional cycling has been associated with as much as a 5-fold increase in the prevalence of atrial fibrillation. 19,30,31,37,[55][56][57][58][59][60][61][62][63] Potential mechanisms underlying the association of long-term excessive exercise and atrial fibrillation are speculative but may include increased vagal and sympathetic tone, bradycardia, inflammatory changes, atrial wall fibrosis, and increased atrial size. 59 Some data indicate that atrial size may be larger in veteran endurance athletes than in age-matched sedentary controls.…”

“…19,30,31,37,[55][56][57][58][59][60][61][62][63] Potential mechanisms underlying the association of long-term excessive exercise and atrial fibrillation are speculative but may include increased vagal and sympathetic tone, bradycardia, inflammatory changes, atrial wall fibrosis, and increased atrial size. 59 Some data indicate that atrial size may be larger in veteran endurance athletes than in age-matched sedentary controls. 64 Indeed, the left atrium may be enlarged in as many as 20% of competitive athletes, and this may be a predictor for atrial fibrillation.…”

“…64 Indeed, the left atrium may be enlarged in as many as 20% of competitive athletes, and this may be a predictor for atrial fibrillation. 59,64 In addition, complex ventricular ectopy, including ventricular tachycardia and rarely SCD, 11 occurs even in very fit individuals. 12,29 Despite the fact that these studies generally excluded athletes with findings suggestive of familial arrhythmogenic RV dysplasia, the VAs typically originate from a mildly dysfunctional RV and/or the interventricular Normal septum.…”

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

“…Aktywność fizyczna jest więc jedną z podstaw zapobiegania AF. 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].…”

Intensive exercise and its effect on the heart: Is more always better?

“…Multiple studies indicate that the risk of AF in athletes is higher compared to non-athletes [5]. It is believed that chronic intensive physical training predisposes to this arrhythmia mostly due to the left atrial enlargement, increased left ventricular mass and increased vagal tone [6].…”