Managing Atrial Fibrillation in Athletes | Overdrive MedscapeTV

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Increased prevalence of atrial fibrillation (Afib) among aging baby boomers has sparked debate among cardiologists about a so-called epidemic of Afib, with some data suggesting that as many as 20% of seniors over 80 will develop the condition. And although age is the most heavily weighted risk factor for the arrhythmia, specialists are beginning to see another population group emerge with its own unique predisposition for Afib: lifelong endurance athletes.
Studies comparing rates of atrial fibrillation among long distance athletes with age-matched control groups have found the incidence of Afib is as much as seven times higher in vigorous exercisers. Experts are starting to understand the underlying physiology that sets up the endurance athlete for vulnerability to Afib. Of particular interest is the impact of intense exercise on atrial remodeling.
Treating this specialized group calls for cardiologists to personalize their approach, finding a balance for patients committed to continuing a highly active lifestyle while minimizing symptoms and risk for stroke.

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26 мар 2021

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@donross7820 7 месяцев назад

I am a 79 year old (in 2 weeks) retired ER physician and I am a rabid advocate of the health benefits of cycling. It truly works miracles and as an example I can still do 4 minute 19 second on the USAA Cycling 5 minute TT (a 4% average upgrade at 6300 foot elevation in Colorado Springs). I weigh low 170 pounds. I can't believe how good I still feel thanks to cycling BUT one area doctors never discuss (and this is huge) is alcohol and the heart. Alcohol is a potent cardiomyotoxin (meaning it is toxic to the heart muscle and causes heart muscle inflammation) but this is dose related. When I was in training I had a 23 year old die from his excessive alcohol intake causing congestive heart failure. In the ER I would see young people come in with an arrhythmia over the holidays due to excessive alcohol (thus the title "Holiday Heart"). As one gets older the risk of Atrial Fibrillation goes up logarithmically and AF can be exercise induced. AF causation is multifactorial and these precipitators make it much more likely during a ride: dehydration, low potassium, hypothermia (even drinking a smoothie can bring it on!), lack of sleep, too much caffeine, thyroid excess, and others. But no one ever seems to bring up the subject of excessive alcohol prior and the risk of AF. I love a nice red wine and this leaves me conflicted but I have found that half a bottle 2-3 days a week seems to not precipitate AF so one does not need to totally do without. My take home message to all us geriatric cycling advocates is keep all those precipitators to a minimum including alcohol and you can continue to partake of the Fountain of Youth and not need what most doctors would recommend: blood thinners or cardiac ablation! Also, watch your heart monitor (Garmin or whatever) like a hawk and when your rate starts getting in the upper ranges just back off to keep it out of trouble. Very high rate from exertion can bring on AF. AND be sure you are not overweight because any fatty tissue on your body gives off inflammatory cytokines (signaling molecules) which leave you in a chronically inflammed state prone to AF (and cancer). 2 days ago I did a 48 mile ride with 5000 feet of climbing and it was wonderful !

@felipesebastiansanchezarev9417 4 месяца назад

It's a great message for popular athletes, I'm a family doctor and I love running and I think sport changed my life, I love it, but this topic scares me, I think that if I control the main precipitating factors such as alcohol, being overweight, the stimulating nervous system, chronic pathologies, maybe I can run all my life without experiencing atrial fibrillation. Thank you.

@SuperOptiman Год назад

This is the first time I have heard this. I (72 year old) am one of these people experiencing Afib (along with Bradycardia) and by many considered athletic--getting up to the point of 100 mile bike rides every day for 45 days.

@stevemurray710 4 месяца назад

70 years old arrhythmia and a higher heart rate seems to come the day after my 5 mile run. Do hit 160 bpm at end. Atrial taccacardia maybe AF have been seen by MD worn 10 days gizmo. Cutting back to walking. So a delay in atrial issue till next day so it seems if running.