Endurance athletes are at a higher risk of atrial fibrillation and atrial dilation than non-athletes, reinforcing the need for careful attention to symptoms even in active patients, Adelaide researchers say. The researchers are urging vigilance for arrhythmias in athletes after their meta-analysis showed extensive endurance training lead to a twofold higher risk of atrial fibrillation […]
Endurance athletes are at a higher risk of atrial fibrillation and atrial dilation than non-athletes, reinforcing the need for careful attention to symptoms even in active patients, Adelaide researchers say.
The researchers are urging vigilance for arrhythmias in athletes after their meta-analysis showed extensive endurance training lead to a twofold higher risk of atrial fibrillation compared to non-athletes.
Being an endurance athlete is often confused with a perceived immunity from lifestyle diseases such as ischemic heart disease, the lead researcher told The Medical Republic.
“Ischemic heart disease can still occur in those who engage in endurance sports and have been shown to be the predominant driver of sudden cardiac events in athletes over the age of 35 years,” said Dr Adrian Elliott, an exercise physiologist from at the Centre for Heart Rhythm Disorders, South Australian Health & Medical Research Institute.
While atrial fibrillation does appear to be increased with endurance training, it still only occurs in a minority of middle-aged patients, he said after presenting the findings of two studies at the 8th Asia Pacific Heart Rhythm Society Scientific Sessions in Melbourne in November.
Their meta-analysis of three cohort studies including 38,000 participants found that those who regularly took part in high aerobic activity for over an hour at a time were at a 3.5% risk of atrial fibrillation, compared to 1.8% in the non-athlete population.
Alongside the meta-analysis, the researchers presented findings from another study of 66 amateur athletes, which showed that atrial dilation occurred in almost a third of those who had accrued more than 6000 hours of endurance training.
“Current estimates suggest that the risk of AF increases in athletes with a history of over 2000 lifetime hours of strenuous endurance exercise,” Dr Elliott said. “It is in this group that we start to observe more pronounced remodelling of the atria.”
“Overall, endurance exercise significantly reduces cardiovascular risk,” Dr Elliott said. “However, a thorough investigation of any endurance sports participant who experiences the common symptoms associated with AF, is warranted.”
“Athletes with atrial arrhythmias commonly notice abnormalities such as abrupt spikes in their heart rate during races or feelings of light headiness, dyspnoea and/or palpitations,” he said.
