[Atrial fibrillation in athletes]

Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting up to 1-1.5% of the population. Regular physical activity reduces the risk of cardiovascular diseases, however several studies have shown paradoxically increased incidence of AF in people practicing sport, especially in elite athletes. The results of studies suggest a U-shape relationship between sport and risk of arrhythmia. Minor regular exertion protects from arrhythmia through reduction in AF risk factors, while intense physical activity increases the risk of arrhythmia. The etiopathogenesis of arrhythmia in athletes has not been fully elucidated yet, but it is definitely multifactorial. Arrhythmia's occurrence may be related to adaptative remodeling of a heart, autonomic nervous system alteration as well as may be associated with other factors like inflammation or dyselectrolitaemia. Atrial Fibrillation in athletes should always be considered as an abnormality which requires further investigation as in small percentage of cases arrhythmia may be the first manifestation of a structural heart disease or chanellopathy potentially leading to sudden cardiac death. Taking into account several problems related to pharmacotherapy, AF ablation has become the first line treatment in athletes.