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Atrial fibrillation among master athletes: A complex relationship.
L Sciarra1, F D'Ascenzi2, A Borrelli3
1Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
International Journal of Cardiology
|February 5, 2026
Summary
Master athletes with atrial fibrillation (AF) have more cardiovascular risk factors like hypertension and dyslipidemia. This suggests a need for personalized risk management in endurance athletes.
Area of Science:
- Cardiology
- Sports Medicine
- Arrhythmology
Background:
- Atrial fibrillation (AF) is a common arrhythmia impacting morbidity and mortality.
- The link between endurance sports and AF in master athletes (≥45 years) is unclear, with potential U-shaped exercise intensity-risk association.
- Moderate activity is generally cardioprotective, but high-intensity endurance training's role in AF requires investigation.
Purpose of the Study:
- To examine the association between endurance sport participation and AF occurrence in master athletes.
- To identify risk factors and predisposing conditions associated with AF in this cohort.
- To compare cardiovascular and extracardiac comorbidities between master athletes with and without AF.
Main Methods:
- An observational case-control study involving 140 master athletes (≥45 years), split into 70 with AF and 70 controls.
- Data collection included demographics, anthropometrics, sports history, comorbidities, 24-h Holter ECG, and echocardiography.
- Statistical analyses were performed to determine significant differences between the AF and control groups.
Main Results:
- The AF and control groups were comparable in age, sex, and BMI, with similar endurance sport patterns.
- Athletes with AF exhibited a higher prevalence of hypertension (73% vs. 21%) and dyslipidemia (54% vs. 14%).
- Larger left atrial size and increased mitral/tricuspid regurgitation were observed in the AF group; most AF cases were paroxysmal.
Conclusions:
- Master athletes with AF demonstrate a greater prevalence of traditional cardiovascular risk factors, especially hypertension and dyslipidemia.
- Individualized cardiovascular assessment and risk management are crucial for master athletes.
- Further longitudinal research is necessary to elucidate the causal relationship between high-intensity endurance exercise and AF development.
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