Atrial Fibrillation in Endurance Training Athletes: Scoping Review

Moderate regular physical activity is indicated to avoid atrial fibrillation (AF), whereas athletes should be counseled that long-lasting vigorous sports engagement may cause AF, according to the 2016 European Society of Cardiology (ESC) recommendations for AF treatment. Exercise and AF are complex....

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Bibliographic Details
Published in:	Reviews in cardiovascular medicine Vol. 24; no. 6; p. 155
Main Authors:	Lobo, Henrique M, Naves, Ícaro G, Marçal, Silvia Botelho, Canzi, Camila Cassia, Rodrigues, Amanda Braun Sabino, Menezes, Jr, Antonio S
Format:	Journal Article
Language:	English
Published:	Singapore IMR Press 01-06-2023
Subjects:	atrial fibrillation cardiac remodeling endurance exercise high-performance athlete physiopathology Review sudden cardiac death atrial fibrillation high-performance athlete physiopathology sudden cardiac death endurance exercise cardiac remodeling
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Summary:	Moderate regular physical activity is indicated to avoid atrial fibrillation (AF), whereas athletes should be counseled that long-lasting vigorous sports engagement may cause AF, according to the 2016 European Society of Cardiology (ESC) recommendations for AF treatment. Exercise and AF are complex. To evaluate the relationship between Endurance training and AF, in addition to the starting point/trigger by which Endurance Training causes impairment of cardiac function and AF, considering the time and intensity of Endurance training. We synthesized evidence from articles published in the PubMed, EMBASE, and SciELO databases using their respective Boolean operators. A total of 112 original articles related to AF and endurance athletes published up to the year 2023 were reviewed. Our study verified multiples aspects of the genesis of AF in athletes, such as cardiac adaptations to exercise, disturbances in cardiac injury biomarkers, sex differences in cardiac adaptations and their role in AF risk, and the relationship between body composition (height, weight, and physical fitness) and AF pathogenesis. Variations in cardiac structure (increased atrial thickness and size in addition to myocardial fibrosis) and significant increases in vagal tone (sinus bradycardia and imbalances in sympathetic and parasympathetic activation) shorten the refractory period shortening in athletes, induce the onset of re-entrance mechanisms, and serve as ectopic triggers that can lead to AF.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 These authors contributed equally.
ISSN:	1530-6550 2153-8174 1530-6550
DOI:	10.31083/j.rcm2406155