Vagal atrial fibrillation: What is it and should we treat it?
Abstract
Vagal atrial fibrillation (AF) remains an under-recognised entity, affecting younger patients often with structurally normal hearts. Although there remains no universal definition or diagnostic criteria, in this review we describe recognised triggers and associated features, including a well-established association with athletic training. We explore potential mechanisms, including the role of the autonomic nervous system and ganglionated plexi in initiating and maintaining arrhythmia. We discuss the limited evidence base addressing the question of progression to persistent AF, and debate the merits of anti-arrhythmic treatment, as well as uncertainty regarding the risk of stroke. Differences in suggested pharmacological therapy are highlighted and as is the emerging promise of radiofrequency catheter ablation as a therapeutic option. As we recognise the emerging burden of vagal AF, we hope to explore the important similarities and differences crucial to developing our understanding of the disorder, and highlight some significant questions which remain unanswered.
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Exercise-related increases in sympathetic tone in endurance athletes could also be predisposing factors for AF.
“Exercise-related increases in sympathetic tone in endurance athletes could also be predisposing factors for AF [58,59].”
From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [58]
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Atrial Fibrillation Triggered By Drug-Induced Bradycardia
Altunbaş, G., Ercan, S., Sucu, M., & Davutoğlu, V. (2016) · Journal of Atrial Fibrillation · doi:10.4022/jafib.1428 · Cited by 3 · see citing works
Atrial fibrillation with slow-ventricular response (AF-SVR): A literature review
Choi, J., Kong, D., Katić, L., Torelli, V. A., Karpenos, J., Marković, N., & Mehta, D. (2025) · The Journal of Medicine Access · doi:10.1177/27550834251342890 · Cited by 2 · see citing works
Multiple Model Predictive Control of the Cardiovascular System Using Vagal Nerve Stimulation
Yao, Y., & Kothare, M. V. (2024) · IEEE Transactions on Control Systems Technology · doi:10.1109/tcst.2024.3473772 · Cited by 1 · see citing works
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The Role of Catheter Ablation in Military Personnel with Atrial Fibrillation
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Elevated Exercise Capacity Mitigates Atrial Fibrillation Incidence and Major Cardiovascular Outcomes
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A Case of Refractory Atrial Tachycardia Inducible Only by Head-up Tilt Test
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Arrhythmias due to athletic training
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Atrial Fibrillation and Sports: Still a Challenging Problem
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Acetylcholine-Induced Atrial Fibrillation: The One-Night Stand
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- Authors
- Carpenter, A., Frontera, A., Bond, R., Duncan, E., & Thomas, G.
- Affiliations
- University Hospitals Bristol NHS Foundation Trust (GB)
- Corresponding author
- Carpenter, Alexander
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2015-12
- Volume
- 201
- Pages
- 415-421
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W1797686712
- Cited by
- 65
- References
- 137
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 4 · 2023: 6 · 2022: 8 · 2021: 6 · 2020: 8 · 2019: 7 · 2018: 4 · 2017: 4 · 2016: 5
- FWCI
- 0.75
- 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 › Cardiac electrophysiology and arrhythmias
- Keywords
- paroxysmal atrial fibrillation, sports training, autonomic nervous system, ganglionated plexi, arrhythmia triggers, antiarrhythmic therapy, stroke risk, radiofrequency catheter ablation, structurally normal heart
- MeSH terms
- Anti-Arrhythmia Agents, Atrial Fibrillation, Humans, Risk Factors, Vagus Nerve, Treatment Outcome, Catheter Ablation
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