The occurrence of atrial fi brillation in former top-level handball players above the age of 50

Abstract

Objective Cardiac adaptation to sports activity in endurance athletes is considerably diff erent from that in power athletes. The eff ects of a highlevel team sport like handball, one of the most popular sports in the world, performed at a younger age, on cardiac rhythm in individuals above the age of 50 have not been investigated to date.Methods Thirty-three former top-level handball players from the fi rst German league (6 former world champions and numerous Olympians) (57.5 ± 5.5 y) joined our screening programme for former athletes and underwent electrocardiography, echocardiography and spiroergometry. Data were compared to 24 sedentary healthy controls.Results Ten of the 33 athletes suff ered from atrial fi brillation (AF). Left ventricular diameter was 53.68 ± 4.88 mm in the athletes group and 50.58 ± 4.12 mm in the healthy controls. Analysing the subgroups of handball players (‘AF group’ and ‘non-AF group’), spiroergometry showed oxygen consumption at the anaerobic threshold of 27.54 ± 6.77 ml/kg/min in the AF group and 31.24 ± 10.33 ml/kg/min in the non-AF group (P = 0.228). Absolute left atrial diameter was 44.34 ± 4.41 mm in the AF group (non-AF group 38.94 ± 3.77 mm, P< 0.001) (healthy controls 37.54 ± 4.34 mm, compared with all athletes P= 0.015). In all individuals left ventricular wall thickness was within normal limits. However, myocardial walls were thicker in the AF group (11.28 ± 1.83 mm) than in the non-AF group (9.44 ± 1.26 mm, P= 0.002). Athletes in the AF group (187.6 ± 6.42 cm) were signifi cantly taller than in the non-AF group (180.91 ± 7.31 cm, P= 0.018).Conclusion Not only endurance training, but also sports activity with a relevant static component, like team handball, might predispose for AF above the age of 50. LA size, height and myocardial wall thickness seem to aff ect the risk of developing AF. More data in non-endurance sports are mandatory to confi rm this hypothesis.