Incidence of Atrial Fibrillation in Agonistic Athletes with Palpitations of Unknown Origin

Vigorous physical exertion may be correlated to a greater incidence of atrial fibrillation (AF). Aim of the study: to evaluate the incidence of AF in agonistic athletes with palpitations of unknown origin. We evaluated 37 athletes (27 m, 28 ± 12 yrs) with palpitations of unknown origin. We performed ECG to exclude ventricular pre-excitation, echocardiography to exclude structural heart disease and transesophageal electrophysiological study (TEES) to evaluate the induction of arrhythmias. 16 pts (43%) were agonistic athletes (A, 13 m, 23 ± 10 yrs), 21 practiced regular physical activities (B, 14 m, 32 ± 12 yrs). In group A, TEES was negative in 50%, AF was induced in 4 pts (25%), atrio-ventricular nodal reentrant tachycardia (AVNRT), unsustained ventricular tachycardia of the right ventricle outflow tract, common atrial flutter (afl) and focal atrial tachycardia (FAT) in 1 pt (6.25%). In group B, TEES was negative in 13 pts (62%), AF was induced in 2 pts (9.5%), AVNRT in 4 (19%) and afl in 2 (9.5%). Among the athletes in which AF was induced (4 pts), 1 stopped agonistic activity. 1) In athletes with palpitations of unknown origin, sustained AF is inducible in 37% of cases during TEES; 2) the inducibility for AF is higher (although not significantly, p=0.2) in agonistic athletes (25%) than in patients practising non agonistic physical activity (9.5%); 3) TEES is useful in the evaluation of athletes with palpitations of unknown origin.