Increased prevalence of atrial fibrillation in the endurance athlete: Potential mechanisms and sport specificity

Physician and Sportsmedicine

Volumn 42, Issue 1, 2014, Pages 45-51

  Olshansky, Brian ^a   Sullivan, Renee ^b  

^a UNIVERSITY OF IOWA   (United States)

^b UNIVERSITY OF MISSOURI   (United States)

Author keywords

Arrhythmia; Atrial fibrillation; Endurance athlete; Exercise intensity

Indexed keywords

C REACTIVE PROTEIN; INTERLEUKIN 6; TUMOR NECROSIS FACTOR ALPHA;

ARTICLE; ATHLETE; ATRIAL FIBRILLATION; CARDIOVASCULAR FUNCTION; CATHETER ABLATION; CYCLING; DISEASE ASSOCIATION; ELECTROCARDIOGRAPHY; ENDURANCE; FOLLOW UP; HEART ARRHYTHMIA; HEART ATRIUM ENLARGEMENT; HEART FAILURE; HUMAN; INCIDENCE; META ANALYSIS (TOPIC); OUTCOME ASSESSMENT; PHYSICAL ACTIVITY; PHYSICAL TOLERANCE; PREVALENCE; RACQUET SPORT; RISK ASSESSMENT; SWIMMING; THROMBOEMBOLISM; WALKING; WOLFF PARKINSON WHITE SYNDROME; EXERCISE; HEART ATRIUM FIBRILLATION; REVIEW; SPORT; STATISTICS;

ATHLETES; ATRIAL FIBRILLATION; EXERCISE; HUMANS; PHYSICAL ENDURANCE; SPORTS;

EID: 84899135984     PISSN: 00913847     EISSN: 23263660     Source Type: Journal    
DOI: 10.3810/psm.2014.02.2047     Document Type: Article

References (39)

1. Mozaffarian D, Furberg CD, Psaty BM, Siscovick D. Physical activity and incidence of atrial fibrillation in older adults: the cardiovascular health study. Circulation. 2008;118(8):800–807.
2. Ofman P, Khawaja O, Rahilly-Tierney CR, et al. Regular physical activity and risk of atrial fibrillation: A systematic review and meta-analysis. Circ Arrhythm Electrophysiol. 2013;6(2):252–256.
3. Aizer A, Gaziano JM, Cook NR, Manson JE, Buring JE, Albert CM. Relation of vigorous exercise to risk of atrial fibrillation. Am J Cardiol. 2009;103(11):1572–1577.
4. Pelliccia A, Maron BJ, Di Paolo FM, et al. Prevalence and clinical significance of left atrial remodeling in competitive athletes. J Am Coll Cardiol. 2005;46(4):690–696.
5. Karjalainen J, Kujala UM, Kaprio J, Sarna S, Viitasalo M. Lone atrial fibrillation in vigorously exercising middle aged men: case-control study. BMJ. 1998;316(7147):1784–1785.
6. Elosua R, Arquer A, Mont L, et al. Sport practice and the risk of lone atrial fibrillation: a case-control study. Int J Cardiol. 2006; 108(3):332–337.
7. Mont L, Sambola A, Brugada J, et al. Long-lasting sport practice and lone atrial fibrillation. Eur Heart J. 2002;23(6):477–482.
8. Grimsmo J, Grundvold I, Maehlum S, Arnesen H. High prevalence of atrial fibrillation in long-term endurance cross-country skiers: echocardiographic findings and possible predictors–a 28–30 years follow-up study. Eur J Cardiovasc Prev Rehabil. 2010;17(1):100–105.
9. Myrstad M, Lochen ML, Graff-Iversen S, et al. Increased risk of atrial fibrillation among elderly Norwegian men with a history of long-term endurance sport practice [published online ahead of print November 21, 2013]. Scand J Med Sci Sports. doi:10.1111/sms.12150.
10. Andersen K, Farahmand B, Ahlbom A, et al. Risk of arrhythmias in 52 755 long-distance cross-country skiers: a cohort study. Eur Heart J. 2013;34(47):3624–3631.
11. Furlanello F, Lupo P, Pittalis M, et al. Radiofrequency catheter ablation of atrial fibrillation in athletes referred for disabling symptoms preventing usual training schedule and sport competition. J Cardiovasc Electrophysiol. 2008;19(5):457–462.
12. Wilhelm M, Roten L, Tanner H, Wilhelm I, Schmid JP, Saner H. Gender differences of atrial and ventricular remodeling and autonomic tone in nonelite athletes. Am J Cardiol. 2011;108(10):1489–1495.
13. Rosengren A, Hauptman PJ, Lappas G, Olsson L, Wilhelmsen L, Swedberg K. Big men and atrial fibrillation: effects of body size and weight gain on risk of atrial fibrillation in men. Eur Heart J. 2009;30(9):1113–1120.
14. Patterson E, Po SS, Scherlag BJ, Lazzara R. Triggered firing in pulmonary veins initiated by in vitro autonomic nerve stimulation. Heart Rhythm. 2005;2(6):624–631.
15. Baldesberger S, Bauersfeld U, Candinas R, et al. Sinus node disease and arrhythmias in the long-term follow-up of former professional cyclists. Eur Heart J. 2008;29(1):71–78.
16. Furlanello F, Bertoldi A, Dallago M, et al. Atrial fibrillation in elite athletes. J Cardiovasc Electrophysiol. 1998;9(8 Suppl):S63–S68.
17. Haissaguerre M, Fischer B, Labbe T, et al. Frequency of recurrent atrial fibrillation after catheter ablation of overt accessory pathways. Am J Cardiol. 1992;69(5):493–497.
18. Heidbuchel H, Anne W, Willems R, Adriaenssens B, Van de Werf F, Ector H. Endurance sports is a risk factor for atrial fibrillation after ablation for atrial flutter. Int J Cardiol. 2006;107(1):67–72.
19. Nattel S, Burstein B, Dobrev D. Atrial remodeling and atrial fibrillation: mechanisms and implications. Circ Arrhythm Electrophysiol. 2008;1(1):62–73.
20. Wijffels MC, Kirchhof CJ, Dorland R, Allessie MA. Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats. Circulation. 1995;92(7):1954–1968.
21. Schotten U, Verheule S, Kirchhof P, Goette A. Pathophysiological mechanisms of atrial fibrillation: a translational appraisal. Physiol Rev. 2011;91(1):265–325.
22. Lindsay MM, Dunn FG. Biochemical evidence of myocardial fibrosis in veteran endurance athletes. Br J Sports Med. 2007;41(7):447–452.
23. Frustaci A, Chimenti C, Bellocci F, Morgante E, Russo MA, Maseri A. Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation. 1997;96(4):1180–1184.
24. Chung MK, Martin DO, Sprecher D, et al. C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation. 2001;104(24):2886–2891.
25. Swanson DR. Atrial fibrillation in athletes: implicit literature-based connections suggest that overtraining and subsequent inflammation may be a contributory mechanism. Med Hypotheses. 2006;66(6):1085–1092.
26. Mann DL, Kent RL, Parsons B, Cooper Gt. Adrenergic effects on the biology of the adult mammalian cardiocyte. Circulation. 1992;85(2):790–804.
27. Scharhag J, Herrmann M, Urhausen A, Haschke M, Herrmann W, Kindermann W. Independent elevations of N-terminal pro-brain natriuretic peptide and cardiac troponins in endurance athletes after prolonged strenuous exercise. Am Heart J. 2005;150(6):1128–1134.
28. Corsetti R, Lombardi G, Barassi A, et al. Cardiac indexes, cardiac damage biomarkers and energy expenditure in professional cyclists during the Giro d’Italia 3-weeks stage race. Biochem Med (Zagreb). 2012;22(2):237–246.
29. Sahlen A, Winter R, Lind B, et al. Magnitude, reproducibility, and association with baseline cardiac function of cardiac biomarker release in long-distance runners aged. or = 55 years. Am J Cardiol. 2008;102(2):218–222.
30. Lowbeer C, Seeberger A, Gustafsson SA, Bouvier F, Hulting J. Serum cardiac troponin T, troponin I, plasma BNP and left ventricular mass index in professional football players. J Sci Med Sport. 2007;10(5):291–296.
31. Date H, Imamura T, Onitsuka H, et al. Differential increase in natriuretic peptides in elite dynamic and static athletes. Circ J. 2003;67(8):691–696.
32. Olshansky B. Interrelationships between the autonomic nervous system and atrial fibrillation. Prog Cardiovasc Dis. 2005;48(1):57–78.
33. Wilhelm M, Zueger T, De Marchi S, et al. Inflammation and atrial remodeling after a mountain marathon [published online ahead of print December 18, 2012]. Scand J Med Sci Sports. doi:10.1111/ sms.12030.
34. Smith LL. Cytokine hypothesis of overtraining: a physiological adaptation to excessive stress? Med Sci Sports Exerc. 2000;32(2):317–331.
35. Deligiannis A, Bjornstad H, Carre F, et al. ESC study group of sports cardiology position paper on adverse cardiovascular effects of doping in athletes. Eur J Cardiovasc Prev Rehabil. 2006;13(5):687–694.
36. Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001;285(22):2864–2870.
37. Wolf PA, Kannel WB, McGee DL, Meeks SL, Bharucha NE, McNamara PM. Duration of atrial fibrillation and imminence of stroke: the Framingham study. Stroke. 1983;14(5):664–667.
38. Lip GY, Frison L, Halperin JL, Lane DA. Identifying patients at high risk for stroke despite anticoagulation: a comparison of contemporary stroke risk stratification schemes in an anticoagulated atrial fibrillation cohort. Stroke. 2010;41(12):2731–2738.
39. Calvo N, Mont L, Tamborero D, et al. Efficacy of circumferential pulmonary vein ablation of atrial fibrillation in endurance athletes. Europace. 2010;12(1):30–36.