Are left atrial remodeling, blood pressure during exercise, and bradyarrhythmia associated with atrial fibrillation in veteran male endurance athletes?
In veteran male endurance athletes, atrial fibrillation appears to be associated with a hypertensive response to exercise rather than left atrial remodeling or fibrosis.
BACKGROUND: Older male endurance athletes exhibit an increased risk of atrial fibrillation (AF) of which the pathogenesis is unclear. We aimed to determine whether left atrial (LA) remodeling on cardiovascular magnetic resonance, blood pressure during exercise, and bradyarrhythmia on implantable loop recorder monitoring were associated with AF in athletes. METHODS: VENTOUX-AF (Cardiac Magnetic Resonance Assessment of Left Atrial Fibrosis in Veteran Endurance Athletes) was a cross-sectional study comparing 39 male athletes with AF (27 symptomatic and 12 detected on implantable loop recorder) aged ≥50 years exercising ≥10 hour/week for ≥15 years with 94 exercise-matched male athletes in sinus rhythm and 33 sedentary male patients with AF. Participants underwent exercise testing and 3-dimensional late-gadolinium enhancement cardiovascular magnetic resonance with LA fibrosis quantification. A total of 106 asymptomatic athletes in sinus rhythm at recruitment received implantable loop recorder to detect incident AF and bradyarrhythmia. RESULTS: <0.001) were greater in athletes with AF than sedentary patients with AF. CONCLUSIONS: Hypertensive response to exercise was common in athletes with AF but LA remodeling and fibrosis were not. Further studies are required to determine whether these factors play a role in the pathogenesis of AF in athletes.
Javed et al. (Mon,) studied this question.