Abstract
Purpose of reviewA complex relationship exists between exercise and atrial fibrillation (AF). Moderate exercise reduces AF risk whereas intense strenuous exercise has been shown to increase AF burden. It remains unclear at which point exercise may become detrimental. Overall, endurance athletes remain at lower cardiovascular risk and experience fewer strokes. The questions that arise therefore are whether AF is an acceptable byproduct of strenuous exercise, whether athletes who experience AF should be told to reduce exercise volume and how should they be managed. This review aims to critically review the literature and advise on how best to manage athletes with AF.Recent findingsEmerging evidence suggests that female athletes may exhibit lower risk of AF, but data is limited in female endurance athletes.SummaryAF is more prevalent in endurance athletes, particularly men and those who competed at a young age. Data is lacking in females and ethnic minorities. Current evidence suggests that treatment options for AF in athletes are similar to those used in the general population; however, medical therapy may be poorly tolerated. Catheter ablation is effective and can allow return to full competition.
Highlights
Atrial fibrillation (AF) is the most common sustained morbidity and mortality worldwide, with complicaarrhythmia, affecting at least 1% of the general popu- tions including thromboembolic stroke [2], cardiac lation [1]
This review aims to evaluate the current literature, in an attempt to assess at what point does exercise increase the risk of atrial fibrillation and represent too much of a good thing, and whether the negative impact of AF ever outweighs the clear benefits of exercise
Athletes dislike taking medication and look for a permanent fix Catheter ablation should be considered in athletes with AF and is often the treatment that the athletes prefer [17]
Summary
Atrial fibrillation (AF) is the most common sustained morbidity and mortality worldwide, with complicaarrhythmia, affecting at least 1% of the general popu- tions including thromboembolic stroke [2], cardiac lation [1]. Sustained endurance training is associated with an increased AF burden [11,12,13,14], moderate exercise is associated with a reduction in AF risk in prospective epidemiological studies [15]. These data are supported by a recent randomized controlled trial demonstrating a reduction in AF burden in an overweight population through moderate exercise [16].
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