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Special Article   

Minerva Cardiology and Angiology 2022 Mar 28

DOI: 10.23736/S2724-5683.22.05842-2

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Atrial fibrillation and sport: need for monitoring

Edoardo BRESSI , Marco REBECCHI, Marianna SGUEGLIA, Cinzia CRESCENZI, Germana PANATTONI, Annamaria MARTINO, Annalisa CASALESE, Catia SANGIORGI, Alessandro POLITANO, Francesco CICOGNA, Alessando FAGAGNINI, Domenico GRIECO, Ermenegildo DE RUVO, Leonardo CALÒ

Department of Cardiology, Policlinico Casilino of Rome, Rome, Italy


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Historically, regular exercise contributed to reduce the arrhythmic burden and improve cardiovascular outcomes in the general population. However, a heightened risk of Atrial Fibrillation (AF) seems to occur mainly amongst endurance athletes. The exact mechanisms are not fully elucidated, but dynamic interactions between electroanatomical changes induced by exercise, the autonomic system, variable triggers, along individual genetic predisposition are the main contributors to AF development in athletes. The type and training load of sports are also crucial in determining the arrhythmogenic milieu predisposing to AF insurgence and perpetuation. Moreover, a sex difference seems to influence an increased risk of AF only in men undergoing strenuous exercise, whereas women appear protected even during more vigorous training. In the absence of solid evidence, the advent of modern technologies could help to monitor and deep investigate the peculiar aspects of AF in these athletes. This review aims to describe the pathophysiology, diagnosis, and management of AF in athletes, shedding light on possible future strategies to face AF in this population.


KEY WORDS: Atrial fibrillation; Athletes; Endurance sport; Electrocardiogram; Wearable devices

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