ArticleEuropean heart journal2025
Atrial fibrillation in former world-class rowers: role of environmental and genetic factors.
Article in European heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Coronary Artery Disease in Masters Athletes: A Systematic Review.Sports medicine (Auckland, N.Z.) · 2026Pooled it
- Critical appraisal on "automatic measuring of coronary atherosclerosis from medicolegal autopsy photographs based on deep learning techniques".Forensic science, medicine, and pathology · 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.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
- Association of self-reported sports volume and discipline with atrial arrhythmia prevalence in middle-aged males.European heart journal open · 2026Article
- Atrial fibrillation risk in athletes: it's not the sport, it's the mileage.European heart journal open · 2026Article
- Atrial Fibrillation in Athletes: Mechanisms, Management, and Future Directions.JACC. Case reports · 2026Article
- Bradycardia in Athletes: Prevalence, Mechanisms, and Risks.Circulation · 2026Article
- Dose-dependent exercise promotes the transition from atrial protection to arrhythmogenic vulnerability: the intermediary role of calcium handling instability in substrate remodeling.Frontiers in physiology · 2026Article
- Atrial fibrillation in elite rowers: a genetic and endurance sport nexus?European heart journal · 2025Article
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Authors and funding
26 authors.
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Abstract
BACKGROUND AND
aimsEndurance sport has been associated with an increased risk of atrial fibrillation (AF). The aim of this study was to assess the extent to which this is due to exercise burden or genetic predisposition.
methodsFormer rowers aged 45-80 years who competed at international championships were compared with a control group extracted from the UK Biobank, matched (1:100) for age and sex. Evaluation included 12-lead and Holter electrocardiograms, cardiac magnetic resonance imaging, and genetic analyses including rare variant evaluation and derivation of a validated AF polygenic risk score (AF-PRS).
resultsOf 121 rowers [age 62 years (interquartile range 54-69), 74% male], 26 (21.5%) had AF as compared with 364 of 11 495 control subjects (3.2%), prevalence risk ratio 6.8 [95% confidence interval (CI) 4.7-9.8]. Incident AF over 4-year follow-up was also greater [6 of 95 rowers (6.3%) vs 252 of 11 131 controls (2.3%), hazard ratio 2.8 (95% CI 1.6-5.0)]. Compared with controls, athletes demonstrated greater structural and electrophysiological cardiac remodelling. Athletes had similar cardiovascular risk factor profiles but a higher stroke prevalence than controls [3.3% vs 1.1%, risk ratio 3.0 (95% CI 1.1-7.9)]. Rare pathogenic and likely pathogenic variants in cardiomyopathy genes had low prevalence in athletes (2.7%) and were not enriched in those with AF. In contrast, in those subjects with a high AF-PRS (defined by the upper quartile in a healthy reference population) the odds of having AF increased 3.7-fold in athletes (95% CI 1.5-9.4) and 2.0-fold in controls (95% CI 1.7-2.4; P = .37 for between-group comparisons).
conclusionsDespite having a favourable cardiovascular risk factor profile compared with controls, elite endurance athletes had a markedly higher prevalence and incidence of AF. These data suggest that exercise-induced cardiac remodelling and genetic susceptibility contribute to AF in endurance athletes.
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