Increased Prevalence of Atrial Fibrillation in the Endurance Athlete: Potential Mechanisms and Sport Specificity

Atrial fibrillation is a common, often symptomatic, and concerning arrhythmia that can lead to heart failure, decreased athletic tolerance, and thromboembolic events; it has also been associated with increased mortality. Although atrial fibrillation is an uncommon condition in younger and otherwise healthy people, recent emerging evidence indicates that endurance athletes may be at particularly high risk of developing atrial fibrillation. We review the evidence that atrial fibrillation is associated with intense endurance athletics and we also explore the mechanisms by which this may occur. Finally, we consider some of the options that are available to treat athletes who develop atrial fibrillation.