Long-Term Sports Practice and Atrial Fibrillation: An Updated Review of a Complex Relationship

Petrungaro, Mattia; Fusco, Liuba; Scarà, Antonio; Borrelli, Alessio; Romano, Silvio; Petroni, Renata; D’Ascenzi, Flavio; Sciarra, Luigi

doi:10.3390/jcdd10050218

Cited by 6 publications

(7 citation statements)

References 94 publications

(144 reference statements)

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“…Moreover, similar findings were demonstrated by Aizer et al in their research on humans [46]. Petrungaro et al indicate that the mechanism of AF in elite athletes is still largely speculative [47]. A large number of studies have shown the higher frequency of this arrhythmia, for example, in marathon runners [46], runners exercising 7 days per week, and long-term competitive swimmers [48].…”

Section: Physical Activitysupporting

confidence: 65%

Associations of Dietary and Lifestyle Components with Atrial Fibrillation

Leszto,

Frąk,

Kurciński

et al. 2024

Nutrients

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Atrial fibrillation (AF) is a prevalent cardiac arrhythmia that still remains a significant health concern, especially due to its consequences, including stroke and heart failure. This review explores the intricate interplay between AF, lifestyle choices, and dietary habits. It is particularly focused on findings from diverse studies about non-pharmacological methods of managing AF. Moreover, its purpose is to elucidate the implementation of lifestyle changes such as physical activity or proper diet choices in the integrated treatment strategy of patients with AF.

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Section: Physical Activitysupporting

confidence: 65%

Associations of Dietary and Lifestyle Components with Atrial Fibrillation

Leszto,

Frąk,

Kurciński

et al. 2024

Nutrients

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“…Studies have observed that the prevalence of AF in athletes is 2–10 times greater than that in the general population ( Sharma, 2018 ). This finding suggests a U-shaped relationship between sports and AF ( Aizer et al, 2009 ; Andersen et al, 2013 ; La Gerche and Schmied, 2013 ; Morseth et al, 2016 ; Sciarra et al, 2022 ; Petrungaro et al, 2023 ), whereby AF seems to increase due to either deficient or excessive sports practice, and patients instead benefit from moderate exercise. The assumed mechanisms underlying this observation include fibrosis or inflammation, hemodynamic variations leading to left atrial enlargement, vagal tone, and genetic factors triggered by physical exercise ( Flannery et al, 2017 ).…”

Section: Prevalence Of Af In Athletesmentioning

confidence: 95%

Thromboembolic prevention in athletes: management of anticoagulation in sports players affected by atrial fibrillation

Minardi,

Sciarra,

Robles

et al. 2024

Front. Pharmacol.

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Atrial fibrillation (AF) is a common cardiac arrhythmia that poses a significant risk of stroke and thromboembolic events. Anticoagulation therapy is essential for preventing stroke in patients with AF. An increasing number of people of all ages, including cardiac patients, approach physical activity as both a leisure-time exercise and a competitive sport. Therefore, patients at risk of AF are increasingly allowed to practice sports activities. Management of oral anticoagulant therapy (OAT) in these patients is extremely challenging because of the need to balance the risks and benefits of medications, considering both hemorrhagic (in case of trauma) and ischemic complications when the drugs are avoided. Official recommendations are limited for these patients and forbid sports that increase the risk of trauma and consequent bleeding in most cases. These recommendations are strongly influenced by the “traditional” management of OAT, which mainly involves coumarin derivatives. Non-vitamin K antagonist direct oral anticoagulants (DOACs), with their more favorable pharmacokinetic–pharmacodynamic profile than that of coumarin derivatives, may represent an opportunity to modify the approach to sports activity in patients with AF and indications for OAT. This study aimed to review the use of anticoagulants in athletes with AF, highlight their efficacy and safety, and provide practical considerations regarding their management.

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“… 5 10 Vigorous exercise has been linked to a higher incidence of AF in veteran male, but not female, endurance athletes, 11 though some studies have found a reduced risk of AF in non-elite moderate physically active men. 12 Additionally, some large population studies have suggested moderate or even vigorous physical activity may reduce the risk of AF in physically active females. 13 14 However, this sex-specific difference in elite endurance athletes has been questioned due to very few studies on female athletes.…”

Section: Introductionmentioning

confidence: 99%

Atrial remodelling associated with sporting discipline, sex and duration in elite sports: a cross-sectional echocardiographic study among Danish elite athletes

Aaroee,

Tischer,

Christensen

et al. 2024

BMJ Open Sport Exerc Med

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BackgroundElite endurance training is characterised by a high-volume load of the heart and has been associated with atrial fibrillation (AF) in middle-aged men. We compared left atrial (LA) remodelling among elite athletes engaged in sports, categorised as having low, intermediate, and high cardiac demands.MethodsThis cross-sectional echocardiographic study of healthy elite athletes evaluated LA size and function measured as LA maximum volume (maxLAVi) and contraction strain. Athletes were grouped according to the cardiac demands of their sport (low, intermediate, high). Morphological measures were indexed to body surface area and reported as least square means; differences between groups were reported with 95% CIs.ResultsWe included 482 elite athletes (age 21±5 years (mean±SD), 39% women). MaxLAVi was larger in the high group (28.4 mL/m2) compared with the low group (20.2 mL/m2; difference: 8.2, CI 5.3 to 11.1 mL/m2; p<0.001), where measurements in men exceed those in women (26.4 mL/m2vs 24.7 mL/m2; difference 1.6 mL/m2; CI 0.3 to 2.9 mL/m2; p=0.0175). In the high group, LA contraction strain was lower compared with the low group (−10.1% vs −12.9%; difference: 2.8%; CI 1.3 to 4.3%; p<0.001), and men had less LA contraction strain compared with women (−10.3% vs −11.0%; difference 0.7%; CI 0.0 to 1.4%; p=0.049). Years in training did not affect maxLAVi or LA contraction strain.ConclusionMaxLAVi was higher while LA contraction strain was lower with increased cardiac demands. MaxLAVi was larger, and LA contraction was lower in men compared with women. Whether these sex-based differences in LA remodelling are a precursor to pathological remodelling in male athletes is unknown.

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Long-Term Sports Practice and Atrial Fibrillation: An Updated Review of a Complex Relationship

Cited by 6 publications

References 94 publications

Associations of Dietary and Lifestyle Components with Atrial Fibrillation

Associations of Dietary and Lifestyle Components with Atrial Fibrillation

Thromboembolic prevention in athletes: management of anticoagulation in sports players affected by atrial fibrillation

Atrial remodelling associated with sporting discipline, sex and duration in elite sports: a cross-sectional echocardiographic study among Danish elite athletes

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