Atrial fibrillation in athletes

Area of Science:

• Cardiology
• Sports Medicine
• Exercise Physiology

Background:

• Long-term endurance sports participation is linked to a higher incidence of atrial fibrillation (AF).
• Potential mechanisms include inflammation, cardiac structural changes, autonomic nervous system dysregulation, and neurohormonal factors.
• Atrial fibrillation can cause symptoms like palpitations and reduced exercise capacity, impacting athletic eligibility.

Purpose of the Study:

• To review the mechanisms, clinical presentation, and management strategies for atrial fibrillation in competitive athletes.
• To discuss criteria for determining eligibility and disqualification from sports participation for athletes with AF.

Main Methods:

• Literature review of studies investigating atrial fibrillation in athletes.
• Analysis of proposed etiological factors and pathophysiological mechanisms.
• Evaluation of current treatment options, including pharmacotherapy and catheter ablation.

Main Results:

• Several factors contribute to AF development in athletes, including inflammation and cardiac remodeling.
• Drug therapy data is limited; catheter ablation is emerging as a viable option for paroxysmal AF in young athletes.
• Sport eligibility decisions require individualized assessment, not automatic disqualification.

Conclusions:

• Atrial fibrillation is a significant concern for endurance athletes, with multifactorial causes.
• Management requires a tailored approach, considering ablation for specific athlete populations.
• Clear guidelines are needed for sport participation eligibility in athletes with atrial fibrillation.