Table 1

Summary of the published studies analysing the relationship between atrial fibrillation and atrial flutter and endurance sport practice

StudiesType of study% MenAge (years)Type of sportsCases/controlsPrevalence of AF (%) (patients/controls)Relative risk for AF
Kaarjalainen et al9Longitudinal case/control10047±5 runnersOrienteering262/3735.3/0.9 (p=0.012)5.5 (95% CI 1.3 to 24.4)
49±5 controls
Mont et al10Retrospective/compared to general population10044±13 sportsEndurance sports >3 h/week70 LAF63/15 (p=0.05)N/R
49±11 non-sports
Elosua et al12Retrospective case/control10041±13 AF patientsEndurance sports51/10932/14 (p=0.01)2.87 (95% CI 1.20 to 6.91)
44±11 controlsCurrent practice and >1500 cumulated hours of practice
Heidbuchel et al14Case/control in patients undergoing flutter ablation8353±9 sports
60±10 controlsCycling, running or swimming >3 h/week31/10681/48 (p<0.01)1.81 (1.10–2.98)
Molina et al15Longitudinal case/control10039±9 runnersMarathon running252/3055/0.7 (p=0.013)8.80 (95% CI 1.2 to 61.2)
50±13 sedentary
Baldesberger et al13Longitudinal case/control10067±7 cyclistCycling134/6210/0 (p=0.028)
66±6 golfers
Mont et al GIRAFA study16Prospective case/control6948±11Endurance sports107/107N/R7.31 (95% CI 2.33 to 22.9)
Grimsmo et al19Prospective100Group I, 54–62; group II, 72–80;group III, 87–92Cross-country skiersGroup I, 33; group II, 37; group III, 812.8% of LAFLong PQ (rr=0.38, p=0.001 and rr=0.27, p=0.02), bradycardia (rr=0.29, p=0.012) were associated risk factors
Winhelm et al20Retrospective10042±7Running70 cases, stratified according to lifetime training hours: low-training group: <1500 h: 17 medium-training group:1500–4500 h: 21 high-training group:>4500 h: 226.7%Signal-averaged P-wave duration (p=0.026), LA volume (p=0.001), vagal activity (p=0.002), PAC (p=0.026) increased in high training group.
  • LA, left atrial; PAC, premature atrial contractions.