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Endurance sports is a risk factor for atrial fibrillation after ablation for atrial flutter
Abstract
Introduction Sports activity has been associated with the development of atrial arrhythmias. Atrial fibrillation (AF) is frequently observed after successful ablation for atrial flutter. Sports activity as a risk factor for AF development after flutter ablation has not been studied.Methods We analyzed outcome in 137 patients (83% men) after ablation for isthmus-dependent atrial flutter (excluding patients with concomitant ablation for atrial tachycardia or fibrillation). Sports activity before and after ablation was evaluated by detailed questionnaires. Endurance sports was defined as (semi-)competitive participation in cycling, running or swimming for > or =3 h/week (and for > or =3 years pre-ablation). Median follow-up was 2.5 years. Survival free of AF was evaluated with Kaplan-Meier curves and log-rank statistics. Multivariate analysis was based on Cox proportional hazard evaluation.Results Acute ablation success was 99% and flutter recurrence 4.4%. Thirty-one patients (23%) had been regularly engaged in endurance sports before ablation and 19 (14%) continued regular sports activity afterwards. Those performing sports were slightly younger. A history of endurance sports was a significant risk factor for post-ablation AF (univariate HR 1.96 (1.19-3.22), p<0.01, and multivariate HR 1.81 (1.10-2.98), p=0.02). Also continuation of endurance sports activity after ablation showed a trend for increased risk to develop AF despite a relatively small sample size (n=19; multivariate HR 1.68 (0.92-3.06), p=0.08). Cox proportional hazard calculations revealed a 10% and 11% increased risk for AF development per weekly hour sport performed before and after ablation respectively (p<0.01 for both).Conclusion A history of endurance sports activity is associated with the development of AF after ablation of atrial flutter.
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“Vigorous exertion and endurance training have been reported to increase atrial fibrillation (AF).”
From Physical Activity and Incidence of Atrial Fibrillation in Older Adults: The Cardiovascular Health Study (2008) · cites this paper as [9]
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“However, only vigorous exertion and endurance training have been evaluated, and largely only in retrospective case-control studies and case series of younger athletes and middle-aged adults.5–11”
From Physical Activity and Incidence of Atrial Fibrillation in Older Adults: The Cardiovascular Health Study (2008) · cites this paper as [9]
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Fragakis, N., Vicedomini, G., & Pappone, C. (2011) · Arrhythmia & Electrophysiology Review · doi:10.15420/aer.2011.3.1.15 · Cited by 19
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Corrado, D., Basso, C., Pelliccia, A., & Thiene, G. (2009) · doi:10.1093/med/9780199566990.003.032 · Cited by 13
Achkasov, E. E., Bondarev, S., Smirnov, V., Waśkiewicz, Z., Rosemann, T. J., Nikolaidis, P. Τ., & Knechtle, B. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16244890 · Cited by 18
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Metadata
- Authors
- Heidbüchel, H., Anné, W., Willems, R., Adriaenssens, B., Van de Werf, F., & Ector, H.
- Affiliations
- Universitair Ziekenhuis Leuven (BE)
- Corresponding author
- Heidbüchel, Hein
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2006-02
- Volume
- 107
- Issue
- 1
- Pages
- 67-72
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2034272555
- Cited by
- 180
- References
- 20
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 7 · 2023: 7 · 2022: 4 · 2021: 6 · 2020: 17 · 2019: 10 · 2018: 11 · 2017: 10 · 2016: 10 · 2015: 15 · 2014: 11 · 2013: 15 · 2012: 10
- FWCI
- 3.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
- Keywords
- endurance sports, atrial fibrillation, atrial flutter, catheter ablation, isthmus-dependent atrial flutter, post-ablation atrial fibrillation, atrial arrhythmias
- MeSH terms
- Atrial Fibrillation, Atrial Flutter, Female, Humans, Male, Middle Aged, Physical Endurance, Prospective Studies, Surveys and Questionnaires, Risk Factors, Sports, Exercise, Proportional Hazards Models, Catheter Ablation, Risk Assessment
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