ArticleOpen heart2022
Risk of atrial fibrillation and stroke among older men exposed to prolonged endurance sport practice: a 10-year follow-up. The Birkebeiner Ageing Study and the Tromsø Study.
Article in Open heart, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Clinical Considerations for Competitive Sports Participation for Athletes With Cardiovascular Abnormalities: A Scientific Statement From the American Heart Association and American College of Cardiology.Journal of the American College of Cardiology · 2025Guideline
- Sex-specific and polygenic effects underlying resting heart rate and associated risk of cardiovascular disease.European journal of preventive cardiology · 2024Pooled it
- Exercise-based cardiac rehabilitation for adults with atrial fibrillation.The Cochrane database of systematic reviews · 2024Pooled it
- Masters Athletes With Abnormal Cardiovascular Findings: A Clinical Consensus Statement of the European Association of Preventive Cardiology of the ESC and the American College of Cardiology.Journal of the American College of Cardiology · 2026Article
- Masters athletes with abnormal cardiovascular findings: a clinical consensus statement of the European Association of Preventive Cardiology of the ESC and the American College of Cardiology.European heart journal · 2026Article
- Atrial fibrillation risk in athletes: it's not the sport, it's the mileage.European heart journal open · 2026Article
- Association of self-reported sports volume and discipline with atrial arrhythmia prevalence in middle-aged males.European heart journal open · 2026Article
- Clinical and Cardiovascular Magnetic Resonance Findings in Endurance Athletes With Symptomatic Stroke.JACC. Case reports · 2026Article
- Lifestyle modification in atrial fibrillation: Mechanisms, phenotypes and ablation outcomes.Experimental physiology · 2026Review
- Atrial fibrillation detection in endurance athletes vs non-athletes: Positive predictive value and burden estimation using implantable cardiac monitors.Heart rhythm O2 · 2026Article
- Effect of sarcopenia on risk of atrial fibrillation: a systematic review and meta-analysis of observational studies.Frontiers in cardiovascular medicine · 2026Review
- Clinical and Cardiovascular Magnetic Resonance Characteristics of Veteran Male Endurance Athletes With Atrial Fibrillation: VENTOUX-AF.Journal of the American Heart Association · 2025Article
- Cardiovascular Remodeling and Potential Controversies in Master Endurance Athletes-A Narrative Review.Life (Basel, Switzerland) · 2025Review
- Observational
- Autonomic Nervous System Activity before Atrial Fibrillation Onset as Assessed by Heart Rate Variability.Reviews in cardiovascular medicine · 2025Article
- Stroke in Athletes with Atrial Fibrillation: A Narrative Review.Diagnostics (Basel, Switzerland) · 2024Review
- Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature.Journal of cardiovascular development and disease · 2024Review
- Racial and Gender Differences in Cardiorespiratory Fitness and Atrial Fibrillation.Reviews in cardiovascular medicine · 2024Review
- Rationale and design of the Birkebeiner Ageing Study - a prospective cohort study of older endurance athletes.BMC geriatrics · 2023Article
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsEndurance sport practice is associated with a high prevalence of atrial fibrillation (AF), which increases the risk of stroke in the general population. However, stroke risk in endurance athletes with AF is sparsely investigated. Most studies have been limited by design and are largely restricted to younger and middle-aged populations. Thus, we aimed to investigate AF and stroke risk in older athletes exposed to prolonged endurance training.
methodDuring a 10-year period, 505 male athletes aged ≥65 years frequently participating in a long-distance ski race were compared with 1867 men of the same age from the general population. The main exposure was endurance sport practice with self-reported AF and stroke as outcomes. Stroke risk was further examined by joint modelling of AF and endurance practice. Statistical analysis was conducted with a modified Poisson model.
resultsAthletes (median age: 68, range: 65-90) participated in a long-distance ski race over a median of 14 years (range: 1-53). Prevalence (28.5% vs 17.8%) and adjusted risk of AF (risk ratio (RR): 1.88, 95% CI: 1.49 to 2.37) were higher in athletes compared with non-athletes, whereas the prevalence (5.4% vs 9.7%) and risk of stroke were lower (RR: 0.60, 95% CI: 0.37 to 0.95). Compared with athletes without AF, risk of stroke was twofold in athletes (RR: 2.38, 95% CI: 1.08 to 5.24) and nearly fourfold in non-athletes (RR: 3.87, 95% CI: 1.98 to 7.57) with AF.
conclusionAlthough older male endurance athletes experienced an increased risk of AF, the long-term risk of stroke was substantially reduced compared with non-athletes.
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Registered trials
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