ReviewEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2009
Endurance sport practice as a risk factor for atrial fibrillation and atrial flutter.
Review in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 102 papers, 7 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
102 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Effects of exercise intervention on physical mobility in stroke patients: a scoping review and research progress.Frontiers in neurology · 2025Pooled it
- Physical activity and risk of atrial fibrillation in the general population: meta-analysis of 23 cohort studies involving about 2 million participants.European journal of epidemiology · 2021Pooled it
- Pooled it
- 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2018Guideline
- European Heart Rhythm Association (EHRA)/European Association of Cardiovascular Prevention and Rehabilitation (EACPR) position paper on how to prevent atrial fibrillation endorsed by the Heart Rhythm Society (HRS) and Asia Pacific Heart Rhythm Society (APHRS).Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2017Guideline
- European Heart Rhythm Association (EHRA)/European Association of Cardiovascular Prevention and Rehabilitation (EACPR) position paper on how to prevent atrial fibrillation endorsed by the Heart Rhythm Society (HRS) and Asia Pacific Heart Rhythm Society (APHRS).European journal of preventive cardiology · 2017Guideline
- Guideline
- Effect of an intensive lifestyle intervention on atrial fibrillation risk in individuals with type 2 diabetes: the Look AHEAD randomized trial.American heart journal · 2015Trial
- Left atrial functional changes following short-term exercise training.European journal of applied physiology · 2014Trial
- Exercise-Induced Hypertension Is Associated with Cardiac Remodeling in Middle-Aged Male Long-Distance Runners: A Cross-Sectional Study.Life (Basel, Switzerland) · 2026Article
- Echocardiographic Parameters and Athlete Performance: Associations and Training Profile Comparisons.Echocardiography (Mount Kisco, N.Y.) · 2026Article
- Modifiable Risk Factors in Atrial Fibrillation: Clinical Implications and Pathophysiological Insights.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2026Review
- Predictive Value of Preoperative Left Atrial Coupling Indices for Postoperative Atrial Fibrillation After Isolated CABG.Medicina (Kaunas, Lithuania) · 2026Article
- Comparison of P wave indices between ultramarathon athletes and general population.Physiological reports · 2026Article
- First-pass isolation and procedural metrics associated with catheter ablation outcomes for atrial fibrillation: a retrospective cohort study.Frontiers in cardiovascular medicine · 2026Article
- Effect of sarcopenia on risk of atrial fibrillation: a systematic review and meta-analysis of observational studies.Frontiers in cardiovascular medicine · 2026Review
- Integrated management of atrial fibrillation and comorbidities in the community: a generalist-specialist collaborative RCT and subgroup analysis.Frontiers in cardiovascular medicine · 2026Article
- Long-Term Outcomes of Drug-Refractory Atrial Fibrillation After Atrioventricular Node Ablation Combined with Implantation of a Cardiac Resynchronization Therapy Defibrillator (CRT-D).Journal of clinical medicine · 2025Article
- Risk of cancer following presentation with new-onset atrial fibrillation using data from UK national databases.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Effects of Acute Exercise Bouts on Cardiovascular Biomarkers in Runners with Exercise-Induced Hypertension.Sports (Basel, Switzerland) · 2025Article
42 more citing papers are in PubMed but not listed here.
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although the benefits of regular exercise in controlling cardiovascular risk factors have been extensively proven, little is known about the long-term cardiovascular effects of regular and extreme endurance sport practice, such as jogging, cycling, rowing, swimming, etc. Recent data from a small series suggest a relationship between regular, long-term endurance sport practice and atrial fibrillation (AF) and flutter. Reported case control studies included less than 300 athletes, with mean age between 40 and 50. Most series recruited only male patients, or more than 70% males, who had been involved in intense training for many years. Endurance sport practice increases between 2 and 10 times the probability of suffering AF, after adjusting for other risk factors. The possible mechanisms explaining the association remain speculative. Atrial ectopic beats, inflammatory changes, and atrial size have been suggested. Some of the published studies found that atrial size was larger in athletes than in controls, and this was a predictor for AF. It has also been shown that the left atrium may be enlarged in as many as 20% of competitive athletes. Other proposed mechanisms are increased vagal tone and bradycardia, affecting the atrial refractory period; however, this may facilitate rather than cause the arrhythmia. In summary, recent data suggest an association between endurance sport practice and atrial fibrillation and flutter. The underlying mechanism explaining this association is unclear, although structural atrial changes (dilatation and fibrosis) are probably present. Larger longitudinal studies and mechanistic studies are needed to further characterize the association to clarify whether a threshold limit for the intensity and duration of physical activity may prevent AF, without limiting the cardiovascular benefits of exercise.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.