Atrial Fibrillation and Sports: Still a Challenging Problem

AbstractAtrial fibrillation (AF) is the most common sustained arrhythmia in athletes. However, the relationship between sport and AF is controversial. On the one hand, some studies report an association between AF incidence and sport; on the other hand, others deny the existence of the latter. Despite this heterogeneity and the possible presence of confounding factors, various studies provide strong evidence that extreme endurance physical activity in elite athletes can increase AF onset in men. However, in recent studies, this association is not confirmed in women: this relationship therefore seems to be linked to sex. In men, it is possible that a strenuous endurance physical activity can lead to cardiac remodelling which, in predisposed subjects, may favour AF induction and maintenance. In this chapter we will focus on the possible mechanisms that could cause atrial fibrillation in athletes, in particular substrate triggers and modulating factor modifications. However, it is important to promote low and moderate physical activity in both men and women, in antagonism to sedentary lifestyle, to prevent cardiovascular diseases, improve quality of life and reduce the risk of AF.KeywordsSportAtrial fibrillationEnduranceSubstrateTriggersModulating factors