Atrial fibrillation in the athlete

Area of Science:

• Cardiology
• Sports Medicine
• Exercise Physiology

Background:

• Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia observed in athletic populations.
• Endurance athletes exhibit a higher incidence of AF compared to sedentary individuals, potentially impacting athletic performance and eligibility.

Purpose of the Study:

• To explore the increased prevalence of atrial fibrillation in athletes.
• To discuss potential etiological mechanisms behind AF in athletes.
• To outline current treatment strategies for AF in athletes.

Main Methods:

• Review of existing evidence on AF in athletes.
• Analysis of proposed mechanisms: morphologic adaptation, autonomic alteration, and chronic inflammation.
• Evaluation of therapeutic approaches including antiarrhythmic drugs and catheter ablation.

Main Results:

• Evidence confirms a higher occurrence of AF in endurance athletes.
• Morphologic adaptation, autonomic alteration, and chronic inflammation are implicated as potential causes.
• Type 1C antiarrhythmics and anticoagulation are first-line treatments.
• Radiofrequency catheter ablation is recommended for refractory or even primary symptomatic paroxysmal AF.

Conclusions:

• Atrial fibrillation presents unique challenges in athletes.
• Understanding the underlying mechanisms is crucial for effective management.
• Pharmacological and interventional treatments offer viable options for athletes with AF.