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The most recent version of this article was published on 11 August 2009

Br J Sports Med. Published Online First: 13 July 2009. doi:10.1136/bjsm.2009.057885
Copyright © 2009 BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine.

Sudden Cardiac Death in Athletes

Atrial Fibrillation in Endurance Trained Athletes

Alexey V Sorokin MD MPH 1, Claudio G S Araujo MD PhD2, Steven Zweibel MD 1 and Paul D Thompson MD 1*

1 Hartford Hospital, United States
2 Clinica de Medicina do Exercico, Rio de Janeiro, Brazil

* To whom correspondence should be addressed. E-mail: pthomps{at}harthosp.org.

Accepted 11 June 2009


Abstract

Endurance exercise training produces multiple cardiac adaptations including changes in electrophysiological function that may make endurance trained athletes more vulnerable to atrial fibrillation (AF). This possible association is not recognized by many practicing cardiologists and sports physicians. Consequently, we performed a literature review to examine the relationship between atrial fibrillation and endurance exercise training among athletes. PubMed was searched from January 1960 through December 2008 to identify articles examining the relationship between endurance exercise training and AF.

Evidence suggests that athletes are at increased risk for development of AF. Possible factors increasing AF in this population include increased parasympathetic tone, reduced sympathetic tone, increased atrial size, and increased inflammation.

Suggested management of AF in athletes should follow similar principles to those used to manage AF in the general population.


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