July 29, 2026European Heart Journal
Ageing, comorbidities, and the complex determinants of atrial fibrillation in athletes
Key result
Lifelong strenuous endurance training linked to ~5- to 8-fold higher AF risk versus non-athletes.
- five- to eight-fold increased risk
Why the study?
Does lifelong strenuous endurance training increase the risk of atrial fibrillation in athletes compared to non-athletes?
Population
Highly trained endurance athletes and master athletes
Comparison
Lifelong strenuous endurance training / vigorous… vs Non-athletes
Design
Review
Authors
Discussion
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Implication
May warrant AF vigilance in lifelong endurance athletes; leaves open causality and thresholds for prospective trials.
Key Points
- To explore how ageing and comorbidities influence the risk of atrial fibrillation in athletes.
- Examined correlation between exercise intensity and cardiovascular outcomes.
- Compared risk of atrial fibrillation in highly trained endurance athletes versus non-athletes.
- Analyzed impact of coronary calcification and myocardial remodelling.
- Strenuous endurance training associates with a five- to eight-fold increased risk of atrial fibrillation compared to non-athletes.
- Master athletes show increased coronary calcification burden.
- Differences in cardiovascular remodelling based on exercise intensity were observed.
Structured PICO
Does lifelong strenuous endurance training increase the risk of atrial fibrillation in athletes compared to non-athletes?
P
Population
Highly trained endurance athletes and master athletes
E
Exposure
Lifelong strenuous endurance training / vigorous exercise training
C
Comparator
Non-athletes
O
Outcome
Atrial fibrillation (AF)
Main Result
Effect estimate: five- to eight-fold increased risk
While moderate exercise is beneficial, lifelong strenuous endurance training is associated with a significantly increased risk of atrial fibrillation.
Cite This Study
Guasch et al. (2021) conducted an editorial in Atrial fibrillation. Lifelong strenuous endurance training vs. Non-athletes was evaluated on Atrial fibrillation (five- to eight-fold increased risk). Lifelong strenuous endurance training is associated with an up to five- to eight-fold increased risk of atrial fibrillation compared with non-athletes.