11/9/2023 0 Comments Endurance sports![]() Indeed, a number of studies have failed to demonstrate any increased risk of AF in female athletes. 14 Unfortunately, it is difficult to derive meaningful conclusions in female athletes as the vast majority of existing literature pertains to male athletes, and sub-group analyses are often underpowered. Whether gender-specific differences occur as it relates to risk of AF and long-term endurance exercise is controversial and represents an active area of investigation. A meta-analysis including six case-control studies corroborated these findings with a five-fold increase in the risk of developing AF among older endurance athletes than non-athletes. 12 In >50,000 skiers, the strongest predictors of AF were the number of races completed and race times. 5-12 The most compelling evidence for a dose- and intensity- dependent association between endurance exercise and AF comes from a long distance competitive skiing event, Vasaloppet, in Sweden. 3,4 However, rather than a linear benefit derived from increasing levels of exercise, there appears to be a threshold beyond which increasing exposure is associated with an increased risk of AF. At low to moderate levels of exercise, there is a lower risk of AF. Several case control studies over the past two decades have revealed the complex relationship between endurance exercise and risk of developing AF. Three months after a moderate exercise 'dose', his symptoms entirely subsided and repeat Holter monitoring revealed no further atrial fibrillation. As the patient was not planning to compete in the near future, he opted to reduce his level of recreational exercise. Echocardiogram revealed normal left atrial size (LAVI 23ml/m2), normal LV dimension (LVIDd 5.2cm), normal LV thickness (posterior wall 1.0cm, septum 0.9cm) and normal ejection fraction. Lab investigations revealed no electrolyte or thyroid abnormalities. He endorsed consuming two glasses of wine per week without binge drinking. He denied taking performance enhancing supplements or caffeinated beverages. He had no significant past medical history but reported a family history of premature coronary artery disease. During sinus rhythm his resting heart rate was 53. Here we describe a case of AF in an athlete and provide a brief overview of the condition and features specific for this highly active population.Ĥ1-year-old male, former US National Team rower and experienced marathon runner, presented with palpitations during rest and AF with a ventricular rate of 140bpm on Holter monitoring. 2 Among athletes, AF impairs cardiac efficiency, affecting exercise capacity and athletic performance. 1 This condition increases the risk of thromboembolic events, heart failure and mortality. Atrial fibrillation (AF) is characterized by irregular atrial activity that replaces normal sinus rhythm leading to loss of the regular atrial contraction during left ventricular diastolic filling.
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