Abstract

Aims To analyse whether the proportion of patients with lone atrial fibrillation engaged in chronic sport practice was higher than that observed in the general population.

Methods and Results The records of 1160 patients, seen at the arrhythmia outpatient clinic, were reviewed. A total of 70 patients (6%) suffered lone atrial fibrillation and were younger than 65 years. Thirty two of them had been engaged in long-term sport practice. All patients in the sport group were men as compared to only 50% in the sedentary group (P<0·0001). To avoid the confounding effect of sex distribution, women were excluded. Sportsmen started their episodes of atrial fibrillation at a younger age, they had a lower incidence of mild hypertension and their episodes of atrial fibrillation were predominantly vagal in contrast to the sedentary patients. The echocardiographic parameters were similar to those observed in the sedentary patients, but when compared with 20 healthy controls, they showed greater atrial and ventricular dimensions and a higher ventricular mass. The proportion of sportsmen among patients with lone atrial fibrillation is much higher than that reported in the general population of Catalonia: 63% vs 15% (P<0·05).

Conclusion Long-term vigorous exercise may predispose to atrial fibrillation.

f1
Correspondence: Lluı́s Mont M.D., Institute of Cardiovascular Diseases, Hospital Clı́nic Universitari de Barcelona,Villarroel 170, Barcelona 08036, Catalonia, Spain

References

1
Brugada
R
, Tapscott T, Grazyna Z. Identification of a genetic locus for familial atrial fibrillation.
N Engl J Med
 .
1997
;
336
:
905
–911
2
Brugada
J
, Mont L, Matas M, Navarro-López F. Atrial fibrillation induced by atrio-ventricular nodal reentrant tachycardia. A curable form of atrial fibrillation.
Am J Cardiol
 .
1997
;
79
:
681
–682
3
Haı̈ssaguerre
M
, Jaı̈s P, Shah DC. Spontaneous initition of atrial fibrillation by ectopic beats originating in the pulmonary veins.
N Engl J Med
 .
1998
;
339
:
659
–666
4
Gallagher
MM
, Camm J. Classification of atrial fibrillation.
Am J Cardiol
 .
1998
;
82
:
18N
–28N
5
Masiá
R
, Pena A, Marrugat J. High prevalence of cardiovascular risk factors in Gerona, Spain, a province with low myocardial infarction incidence.
J Epidemiol Community Health
 .
1998
;
52
:
707
–715
6
Elosua
R
, Marrugat J, Molina L, Pons S, Pujol E. Validation of the Minnesota Leisure Time Physical Activity Questionnaire in Spanish men.
Am J Epidemiol
 .
1994
;
139
:
1197
–1209
7
Devereux
RB
, Reichek N. Echocardiographic determination of the left ventricular mass in men. Anatomic validation of the method.
Circulation
 .
1977
;
55
:
613
–618
8
SPSS for Windows base system user's guide release 6.0. Chicago: SPSS Inc; 1993.
9
Ettinger
PO
, Wu CF, De La Cruz C, Weisse AB, Ahmed SS, Regan TJ. Arrhythmias and the holiday heart: alcohol associated cardiac rhythm disorders.
Am Heart J
 .
1978
;
95
:
555
–562
10
Gallagher
KM
, Raven PB, Mitchell JH. Classification of sports and the athlete heart. Williams RA. The Athlete and heart disease: diagnosis, evaluation and treatment. Philadelphia: Lippincott, Williams & Wilkins; 1999. p. 9–21
11
Morganroth
J
, Maron BJ, Henry WL, Epstein SE. Comparative left ventricular dimensions in trained athletes.
Ann Intern Med
 .
1975
;
82
:
521
–524
12
Pellicia
A
, Maron BJ, Spataro A, Proschan MA, Spirito P. The upper limit of physiologic hypertrophy in highly trained elite athletes.
N Engl J Med
 .
1991
;
324
:
295
–301
13
Spirito
P
, Pellicia A, Proschan MA. Morphology of the ‘athlete’s heart' assessed by echocardiography in 947 elite athletes representing 27 sports.
Am J Cardiol
 .
1994
;
74
:
802
–806
14
Boraita
A
, Serratosa L. El corazón del deportista: hallazgos electrocardiográficos más frecuentes.
Rev Esp Cardiol
 .
1998
;
51
:
356
–368
15
Pluim
BM
, Zwinderman AH, van der Laarse A, van der Wall EE. The athlete's heart. A meta-analysis of cardiac structure an function.
Circulation
 .
1999
;
100
:
336
–344
16
Zehender
M
, Meinertz T, Keul J, Just H. ECG variants and cardiac arrhythmias in athletes: clinical relevance and prognostic importance.
Am Heart J
 .
1990
;
119
:
1378
–1391
17
Viitasalo
M
, Kala R, Eisalo A. Ambulatory electrocardiographic recording in endurance athletes.
Br Heart J
 .
1982
;
47
:
213
–220
18
Bjornstad
H
, Storstein L, Dyre H, Hals O. Ambulatory Electrocardiographic findings in Top Athletes, Athletic Students and Control Subjects.
Cardiology
 .
1994
;
84
:
42
–50
19
Link
MS
, Wang PJ, Estes NA III. Cardiac arrhythmias and electrophysiologic observations in the athlete. Williams RA. The Athlete and Heart Disease: Diagnosis, Evaluation and Management. Philadelphia: Lippincott, Williams & Wilkins; 1999. p. 197–216
20
Coelho
A
, Palileo E, Ashley W. Tachyarrhythmias in young athletes.
J Am Coll Cardiol
 .
1986
;
7
:
237
–243
21
Furlanello
F
, Bertoldi A, Dallago M. Atrial fibrillation in top-level athletes. Olsson SB, Allessie MA, Campbell RWF. Atrial Fibrillation: Mechanisms and Therapeutic Strategies. Armonk: Futura Publishing Co. Inc; 1994. p. 203–209
22
Karjalainen
J
, Kujala U, Kaprio J, Seppo S, Viitasalo M. Lone atrial fibrillation in vigorously exercising middle aged men: case-control study.
BMJ
 .
1998
;
316
:
1784
–1785
23
Hoff
HE
, Geddes LA. Cholinergic factor in atrial fibrillation.
J Appl Physiol
 .
1955
;
8
:
177
–192
24
Moe
GK
, Abildskov JA. Atrial fibrillation as a self-sustaining arrhthmia independent of cocal discharge.
Am Heart J
 .
1959
;
58
:
59
–70
25
Janse
MJ
, Allessie MA. Experimental observations in atrial fibrillation. Falk RH, Podrid PJ. Atrial Fibrillation; Mechanisms and Management. New York: Lippincott-Raven; 1997. p. 53–73
26
Alessie
R
, Nusynowitz M, Abildskow J, Moe G. Non-uniform distribution of vagal effects on the atrial refractory period.
Am J Physiol
 .
1958
;
194
:
406
–410
27
Morillo
CA
, Klein GJ, Jones DL, Guiraudon CM. Chronic rapid atrial pacing. Structural, functional and electrophysiological characteristics of a new model of sustained atrial fibrillation.
Circulation
 .
1995
;
91
:
1588
–1595
28
Coumel
P
, Attuel P, Lavallée JP, Flammang D, Leclercq JF, Slama R. Syndrome d'arythmie auriculaire d'origine vagale.
Arch Mal Coeur
 .
1978
;
71
:
645
–656
29
Coumel
P
. Paroxysmal atrial fibrillation: a disorder of autonomic tone?
Eur Heart J
 .
1994
;
15
:
9
–16
30
Coumel
P
. The role of the autonomic nervous system in atrial flutter and fibrillation: Clinical findings. Saoudi N, Schoels W, El-Sherif N. Atrial Flutter and Fibrillation from Basic to Clinical Applications. Armonk: Futura Publishing Co; 1998. p. 89–105
31
Sopher
SM
, Malik M, Camm AJ. Neural aspects of atrial fibrillation. Falk RH, Podrid PJ. Atrial Fibrillation; Mechanisms and Management. New York: Lippincott-Raven; 1997. p. 53–73
32
Clementy
J
, Dulhoste MN, Laiter C, Denjoy I, Dos Santos P. Flecainide acetate in the prevention of paroxysmal atrial fibrillation: a nine-month follow-up of more than 500 patients.
Am J Cardiol
 .
1992
;
70
:
44A
–49A

Comments

0 Comments