Atrial Fibrillation Promotion by Endurance Exercise
Open accessAbstract
Objectives The goal of this study was to assess mechanisms underlying atrial fibrillation (AF) promotion by exercise training in an animal model.Background High-level exercise training promotes AF, but the underlying mechanisms are unclear.Methods AF susceptibility was assessed by programmed stimulation in rats after 8 (Ex8) and 16 (Ex16) weeks of daily 1-h treadmill training, along with 4 and 8 weeks after exercise cessation and time-matched sedentary (Sed) controls. Structural remodeling was evaluated by using serial echocardiography and histopathology, autonomic nervous system with pharmacological tools, acetylcholine-regulated potassium current (IKACh) with patch clamp recording, messenger ribonucleic acid expression with quantitative polymerase chain reaction, and regulators of G protein-signaling (RGS) 4 function in knockout mice.Results AF inducibility increased after 16 weeks of training (e.g., AF >30 s in 64% of Ex16 rats vs 15% of Sed rats; p < 0.01) and rapidly returned to baseline levels with detraining. Atropine restored sinus rhythm in 5 of 5 Ex rats with AF sustained >15 min. Atrial dilation and fibrosis developed after 16 weeks of training and failed to fully recover with exercise cessation. Parasympathetic tone was increased in Ex16 rats and normalized within 4 weeks of detraining. Baroreflex heart rate responses to phenylephrine-induced blood pressure elevation and IKACh sensitivity to carbachol were enhanced in Ex16 rats, implicating both central and end-organ mechanisms in vagal enhancement. Ex rats showed unchanged cardiac adrenergic and cholinergic receptor and IKACh-subunit gene expression, but significant messenger ribonucleic acid downregulation of IKACh-inhibiting RGS proteins was present at 16 weeks. RGS4 knockout mice showed significantly enhanced sensitivity to AF induction in the presence of carbachol.Conclusions Chronic endurance exercise increased AF susceptibility in rats, with autonomic changes, atrial dilation, and fibrosis identified as potential mechanistic contributors. Vagal promotion is particularly important and occurs via augmented baroreflex responsiveness and increased cardiomyocyte sensitivity to cholinergic stimulation, possibly due to RGS protein downregulation.
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The increased risk of AF from intensive sports practice is probably mediated by altered autonomic tone, volume load during exercise, atrial hypertrophy, and dilatation.
“probably mediated by altered autonomic tone, volume load during exercise, atrial hypertrophy, and dilatation.903,904”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [904]
Detraining can reduce AF in models and reduces ventricular arrhythmias in athletes.
“Detraining can reduce AF in models 904 and reduces ventricular arrhythmias in athletes, 907”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [904]
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Compendium of physical activities: an update of activity codes and MET intensities
AINSWORTH, B. E., HASKELL, W. L., WHITT, M. C., IRWIN, M. L., SWARTZ, A. M., STRATH, S. J., O???BRIEN, W. L., BASSETT, D. R., SCHMITZ, K. H., EMPLAINCOURT, P. O., et al. (2000) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200009001-00009 · Cited by 8,497 · see citing works
Promotion of Atrial Fibrillation by Heart Failure in Dogs
Li, D., Fareh, S., Leung, T. K., & Nattel, S. (1999) · Circulation · doi:10.1161/01.cir.100.1.87 · Cited by 1,343 · see citing works
Self-citationAtrial Fibrillation Pathophysiology
Iwasaki, Y., Nishida, K., Kato, T., & Nattel, S. (2011) · Circulation · doi:10.1161/circulationaha.111.019893 · Cited by 852 · see citing works
Self-citationLawler, P. R., Filion, K. B., & Eisenberg, M. J. (2011) · American Heart Journal · doi:10.1016/j.ahj.2011.07.017 · Cited by 701 · see citing works
Verheule, S., Sato, T., Everett, T. H., Engle, S. K., Otten, D., Rubart, M., Nakajima, H. O., Nakajima, H., Field, L. J., & Olgin, J. E. (2004) · Circulation Research · doi:10.1161/01.res.0000129579.59664.9d · Cited by 551 · see citing works
Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training
Benito, B., Gay-Jordi, G., Serrano-Mollar, A., Guasch, E., Shi, Y., Tardif, J.-C., Brugada, J., Nattel, S., & Mont, L. (2011) · Circulation · doi:10.1161/circulationaha.110.938282 · Cited by 478 · see citing works
Self-citationPrevalence and Clinical Significance of Left Atrial Remodeling in Competitive Athletes
Pelliccia, A., Maron, B. J., Di Paolo, F. M., Biffi, A., Quattrini, F. M., Pisicchio, C., Roselli, A., Caselli, S., & Culasso, F. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.04.052 · Cited by 443 · see citing works
Liu, L., & Nattel, S. (1997) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.1997.273.2.h805 · Cited by 424 · see citing works
Self-citationRemodeling of Left Ventricular Hypertrophy in Elite Athletes After Long-Term Deconditioning
Pelliccia, A., Maron, B. J., De Luca, R., Di Paolo, F. M., Spataro, A., & Culasso, F. (2002) · Circulation · doi:10.1161/hc0802.104534 · Cited by 390 · see citing works
Relation of vigorous exercise to risk of atrial fibrillation
Aizer, A., Gaziano, J. M., Cook, N. R., Manson, J. E., Buring, J. E., & Albert, C. M. (2009) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2009.01.374 · Cited by 383 · cited 1× · see citing works
“However, the AF risk is not confined to elite athletes: a dose–response relationship has been seen in men aged younger than 50 years and in joggers (7).”
BackgroundFagard, R. H. (2003) · Heart · doi:10.1136/heart.89.12.1455 · Cited by 371 · see citing works
Yue, L., Xie, J., & Nattel, S. (2010) · Cardiovascular Research · doi:10.1093/cvr/cvq329 · Cited by 362 · see citing works
Self-citationSinus node disease and arrhythmias in the long-term follow-up of former professional cyclists
Baldesberger, S., Bauersfeld, U., CANDINAS, R., Seifert, B., Zuber, M., Ritter, M., Jenni, R., Oechslin, E. N., Luthi, P., Scharf, C., et al. (2007) · European Heart Journal · doi:10.1093/eurheartj/ehm555 · Cited by 343 · see citing works
Long-lasting sport practice and lone atrial fibrillation
Mont, L. (2002) · European Heart Journal · doi:10.1053/euhj.2001.2802 · Cited by 331 · see citing works
Self-citationMolina, L., Mont, L., Marrugat, J., Berruezo, A., Brugada, J., Bruguera, J., Rebato, C., & Elosua, R. (2008) · EP Europace · doi:10.1093/europace/eun071 · Cited by 327 · see citing works
Self-citationEndurance sport practice as a risk factor for atrial fibrillation and atrial flutter
Mont, L., Elosua, R., & Brugada, J. (2008) · Europace · doi:10.1093/europace/eun289 · Cited by 287 · see citing works
Self-citationSport practice and the risk of lone atrial fibrillation: a case-control study
Elosua, R., Arquer, A., Mont, L., Sambola, A., Molina, L., García-Morán, E., Brugada, J., & Marrugat, J. (2006) · International Journal of Cardiology · doi:10.1016/j.ijcard.2005.05.020 · Cited by 250 · see citing works
Self-citationGerche, A. L., Robberecht, C., Kuipéri, C., Nuyens, D., Willems, R., de Ravel, T. J. L., Matthijs, G., & Heidbüchel, H. (2010) · Heart · doi:10.1136/hrt.2009.189621 · Cited by 219 · see citing works
Changes in Connexin Expression and the Atrial Fibrillation Substrate in Congestive Heart Failure
Burstein, B., Comtois, P., Michael, G., Nishida, K., Villeneuve, L. R., Yeh, Y., & Nattel, S. (2009) · Circulation Research · doi:10.1161/circresaha.108.183400 · Cited by 210 · see citing works
Self-citationEndurance sports is a risk factor for atrial fibrillation after ablation for atrial flutter
Heidbüchel, H., Anné, W., Willems, R., Adriaenssens, B., Van de Werf, F., & Ector, H. (2006) · International Journal of Cardiology · doi:10.1016/j.ijcard.2005.02.043 · Cited by 180 · see citing works
Grimsmo, J., Grundvold, I., Maehlum, S., & Arnesen, H. (2010) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/hjr.0b013e32833226be · Cited by 176 · see citing works
Collier, S. R., Kanaley, J. A., Carhart, R. L., Frechette, V., Tobin, M. M., Bennett, N. L., Luckenbaugh, A. N., & Fernhall, B. (2008) · Acta Physiologica · doi:10.1111/j.1748-1716.2008.01897.x · Cited by 145 · see citing works
RGS4 Regulates Parasympathetic Signaling and Heart Rate Control in the Sinoatrial Node
Cifelli, C., Rose, R. A., Zhang, H., Voigtlaender‐Bolz, J., Bolz, S., Backx, P. H., & Heximer, S. P. (2008) · Circulation Research · doi:10.1161/circresaha.108.180984 · Cited by 132 · see citing works
Self-citationFu, Y., Huang, X., Zhong, H., Mortensen, R. M., D’Alecy, L. G., & Neubig, R. R. (2006) · Circulation Research · doi:10.1161/01.res.0000207497.50477.60 · Cited by 92 · see citing works
Gu, S., Cifelli, C., Wang, S., & Heximer, S. P. (2009) · Clinical Science · doi:10.1042/cs20080272 · Cited by 72 · see citing works
Self-citationPietilä, M., Malminiemi, K., Vesalainen, R. K., Jartti, T. T., Teräs, M., Någren, K., Lehikoinen, P., & Voipio‐Pulkki, L. (2002) · PubMed · Cited by 54 · see citing works
Nattel, S. (2011) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2010.11.004 · Cited by 50 · see citing works
Self-citationBender, K., Nasrollahzadeh, P., Timpert, M., Liu, B., Pott, L., & Kienitz, M. (2008) · The Journal of Physiology · doi:10.1113/jphysiol.2007.148346 · Cited by 33 · see citing works
Boknı́k, P., Grote-Wessels, S., Barteska, G., Jiang, M., Müller, F., Schmitz, W. L., Neumann, J., & Birnbaumer, L. (2009) · British Journal of Pharmacology · doi:10.1111/j.1476-5381.2009.00441.x · Cited by 22 · see citing works
Enlarged Left Atrial Dimension in Former Endurance Athletes: An Echocardiographic Study
Höglund, C. (1986) · International Journal of Sports Medicine · doi:10.1055/s-2008-1025750 · Cited by 21 · see citing works
Laroche, G., Giguère, P. M., Roth, B. L., Trejo, J., & Siderovski, D. P. (2010) · American Journal of Physiology-Cell Physiology · doi:10.1152/ajpcell.00441.2009 · Cited by 17 · see citing works
Nattel, S. (2008) · Heart Rhythm · doi:10.1016/j.hrthm.2008.11.028 · Cited by 6 · see citing works
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Flagged first, then by citations
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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P. F., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castellà, M., Diener, H., Heidbüchel, H., Hendriks, J., et al. (2016) · EP Europace · doi:10.1093/europace/euw295 · Cited by 6,438 · see citing works
Self-citation2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
Self-citationEpidemiology of Atrial Fibrillation in the 21st Century
Kornej, J., Börschel, C. S., Benjamin, E. J., & Schnabel, R. B. (2020) · Circulation Research · doi:10.1161/circresaha.120.316340 · Cited by 1,550 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezw313 · Cited by 1,403 · see citing works
Self-citationThe Clinical Profile and Pathophysiology of Atrial Fibrillation
Andrade, J. G., Khairy, P., Dobrev, D., & Nattel, S. (2014) · Circulation Research · doi:10.1161/circresaha.114.303211 · Cited by 1,206 · see citing works
Self-citationRole of the Autonomic Nervous System in Atrial Fibrillation
Chen, P., Chen, L. S., Fishbein, M. C., Lin, S., & Nattel, S. (2014) · Circulation Research · doi:10.1161/circresaha.114.303772 · Cited by 798 · see citing works
Self-citationHeijman, J., Voigt, N., Nattel, S., & Dobrev, D. (2014) · Circulation Research · doi:10.1161/circresaha.114.302226 · Cited by 681 · see citing works
Self-citationModifiable Risk Factors and Atrial Fibrillation
Lau, D. H., Nattel, S., Kalman, J. M., & Sanders, P. (2017) · Circulation · doi:10.1161/circulationaha.116.023163 · Cited by 595 · see citing works
Self-citationExercise and the heart: the good, the bad, and the ugly
Sharma, S., Merghani, A., & Mont, L. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv090 · Cited by 398 · see citing works
Self-citationEpidemiology and modifiable risk factors for atrial fibrillation
Elliott, A. D., Middeldorp, M. E., Gelder, I. C. V., Albert, C. M., & Sanders, P. (2023) · Nature Reviews Cardiology · doi:10.1038/s41569-022-00820-8 · Cited by 380 · see citing works
Brieger, D. B., Amerena, J. V., Attia, J., Bajorek, B. V., Chan, K. H., Connell, C., Freedman, B., Ferguson, C., Hall, T. L., Haqqani, H. M., et al. (2018) · Heart Lung and Circulation · doi:10.1016/j.hlc.2018.06.1043 · Cited by 328 · see citing works
Exercise training reduces resting heart rate via downregulation of the funny channel HCN4
D’Souza, A., Bucchi, A., Johnsen, A. B., Logantha, S. J. R. J., Monfredi, O., Yanni, J., Prehar, S., Hart, G., Cartwright, E. J., Wisløff, U., et al. (2014) · Nature Communications · doi:10.1038/ncomms4775 · Cited by 275 · see citing works
Malmo, V., Nes, B. M., Amundsen, B. H., Tjonna, A.-E., Stoylen, A., Rossvoll, O., Wisloff, U., & Loennechen, J. P. (2016) · Circulation · doi:10.1161/circulationaha.115.018220 · Cited by 263 · see citing works
Animal models of arrhythmia: classic electrophysiology to genetically modified large animals
Clauß, S., Bleyer, C., Schüttler, D., Tomsits, P., Renner, S., Klymiuk, N., Wakili, R., Maßberg, S., Wolf, E., & Kääb, S. (2019) · Nature Reviews Cardiology · doi:10.1038/s41569-019-0179-0 · Cited by 222 · see citing works
Aschar-Sobbi, R., Izaddoustdar, F., Korogyi, A. S., Wang, Q., Farman, G. P., Yang, F., Yang, W., Dorian, D., Simpson, J. A., Tuomi, J. M., et al. (2015) · Nature Communications · doi:10.1038/ncomms7018 · Cited by 185 · see citing works
Novel mechanisms in the pathogenesis of atrial fibrillation: practical applications
Lau, D. H., Schotten, U., Mahajan, R., Antic, N. A., Hatem, S. N., Pathak, R. K., Hendriks, J., Kalman, J. M., & Sanders, P. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv375 · Cited by 171 · see citing works
The U-shaped relationship between exercise and cardiac morbidity
Merghani, A., Malhotra, A., & Sharma, S. (2015) · Trends in Cardiovascular Medicine · doi:10.1016/j.tcm.2015.06.005 · Cited by 173 · see citing works
Mortality of French participants in the Tour de France (1947-2012)
Marijon, É., Tafflet, M., Antero, J., Helou, N. E., Berthelot, G., Celermajer, D. S., Bougouin, W., Combes, N., Hermine, O., Empana, J. P., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht347 · Cited by 170 · see citing works
Lampert, R., Chung, E. H., Ackerman, M. J., Arroyo, A. R., Darden, D., Deo, R., Dolan, J., Etheridge, S. P., Gray, B. R., Harmon, K. G., et al. (2024) · Heart Rhythm · doi:10.1016/j.hrthm.2024.05.018 · Cited by 167 · see citing works
Self-citationTranslational Challenges in Atrial Fibrillation
Heijman, J., Guichard, J.-B., Dobrev, D., & Nattel, S. (2018) · Circulation Research · doi:10.1161/circresaha.117.311081 · Cited by 165 · see citing works
Self-citationLinz, D., Ukena, C., Mahfoud, F., Neuberger, H., & Böhm, M. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.09.020 · Cited by 153 · see citing works
Calvo, N., Ramos, P., Montserrat, S., Guasch, E., Coll-Vinent, B., Domenech, M., Bisbal, F., Hevia, S., Vidorreta, S., Borras, R., et al. (2016) · Europace · doi:10.1093/europace/euv216 · Cited by 153 · see citing works
Self-citationAtrial Fibrillation: Mechanisms, Therapeutics, and Future Directions
Pellman, J., & Sheikh, F. (2015) · Comprehensive physiology · doi:10.1002/cphy.c140047 · Cited by 178 · see citing works
Fabritz, L., Guasch, E., Antoniades, C. A., Bardinet, I., Benninger, G., Betts, T. R., Brand, E., BREITHARDT, G. E., Suchánková, G., Camm, A. J., et al. (2015) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2015.194 · Cited by 142 · see citing works
Self-citationPrevention of Pathological Atrial Remodeling and Atrial Fibrillation
Chen, Y. C., Voskoboinik, A., Gerche, A. L., Marwick, T. H., & McMullen, J. R. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.04.012 · Cited by 140 · see citing works
Self-citationOdening, K. E., Deiß, S., Dilling-Boer, D. M., Didenko, M., Eriksson, U., Nedios, S., Ng, F. S., Roca‐Luque, I., Borque, P. S., Vernooy, K., et al. (2018) · EP Europace · doi:10.1093/europace/euy215 · Cited by 138 · see citing works
Diagnosis, pathophysiology, and management of exercise-induced arrhythmias
Guasch, E., & Mont, L. (2017) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2016.173 · Cited by 134 · see citing works
Self-citationCan Intensive Exercise Harm the Heart?
Gerche, A. L., & Heidbüchel, H. (2014) · Circulation · doi:10.1161/circulationaha.114.008141 · Cited by 132 · see citing works
Epigenetic adaptation to regular exercise in humans
Ling, C., & Rönn, T. (2014) · Drug Discovery Today · doi:10.1016/j.drudis.2014.03.006 · Cited by 114 · see citing works
An Exercise and Physical Activity Program in Patients With Atrial Fibrillation
Elliott, A. D., Verdicchio, C. V., Mahajan, R., Middeldorp, M. E., Gallagher, C., Mishima, R. S., Hendriks, J. M. L., Pathak, R. K., Thomas, G., Lau, D. H., et al. (2023) · JACC: Clinical Electrophysiology · doi:10.1016/j.jacep.2022.12.002 · Cited by 116 · see citing works
State of the Art Review: Atrial Fibrillation in Athletes
Flannery, D., Kalman, J. M., Sanders, P., & Gerche, A. L. (2017) · Heart Lung and Circulation · doi:10.1016/j.hlc.2017.05.132 · Cited by 110 · see citing works
D’Souza, A., Pearman, C. M., Wang, Y., Nakao, S., Logantha, S. J. R. J., Cox, C., Bennett, H. J., Zhang, Y., Johnsen, A. B., Linscheid, N., et al. (2017) · Circulation Research · doi:10.1161/circresaha.117.311607 · Cited by 110 · see citing works
The Athlete’s Heart—Challenges and Controversies
Gerche, A. L., Wasfy, M. M., Brosnan, M. J., Claessen, G., Fatkin, D., Heidbüchel, H., Baggish, A. L., & Kovacic, J. C. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2022.07.014 · Cited by 109 · see citing works
The effects of endurance exercise on the heart: panacea or poison?
Parry-Williams, G., & Sharma, S. (2020) · Nature Reviews Cardiology · doi:10.1038/s41569-020-0354-3 · Cited by 102 · see citing works
Physical Activity and Risk of Atrial Fibrillation: A Nationwide Cohort Study in General Population
Jin, M.-N., Yang, P.-S., Song, C., Yu, H. T., Kim, T.-H., Uhm, J.-S., Sung, J.-H., Pak, H.-N., Lee, M.-H., & Joung, B. (2019) · Scientific Reports · doi:10.1038/s41598-019-49686-w · Cited by 99 · see citing works
Dynamics of Atrial Fibrillation Mechanisms and Comorbidities
Heijman, J., Linz, D., & Schotten, U. (2020) · Annual Review of Physiology · doi:10.1146/annurev-physiol-031720-085307 · Cited by 97 · see citing works
Clauß, S., Wakili, R., Hildebrand, B., Kääb, S., Hoster, E., Klier, I., Martens, E., Hanley, A., Hanssen, H., Halle, M., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0148599 · Cited by 97 · see citing works
New Findings in Atrial Fibrillation Mechanisms
Lau, D. H., Linz, D., & Sanders, P. (2019) · Cardiac Electrophysiology Clinics · doi:10.1016/j.ccep.2019.08.007 · Cited by 93 · see citing works
Atrial fibrillation in highly trained endurance athletes — Description of a syndrome
Sanchis-Gomar, F., Perez-Quilis, C., Lippi, G., Cervellin, G., Leischik, R., Löllgen, H., Serrano-Ostáriz, E., & Lucia, A. (2017) · International Journal of Cardiology · doi:10.1016/j.ijcard.2016.10.047 · Cited by 95 · see citing works
La Gerche, A., Inder, W. J., Roberts, T. J., Brosnan, M. J., Heidbuchel, H., & Prior, D. L. (2015) · PLOS ONE · doi:10.1371/journal.pone.0130031 · Cited by 80 · see citing works
Atrial fibrillation in athletes and the interplay between exercise and health
Gerche, A. L., & Schmied, C. M. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht265 · Cited by 78 · see citing works
Nyns, E. C. A., Poelma, R. H., Volkers, L., Plomp, J. J., Bart, C. I., Kip, A., van Brakel, T. J., Zeppenfeld, K., Schalij, M. J., Zhang, G., et al. (2019) · Science Translational Medicine · doi:10.1126/scitranslmed.aau6447 · Cited by 71 · see citing works
Immune remodeling and atrial fibrillation
Yao, Y., Yang, M., Liu, D., & Zhao, Q. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.927221 · Cited by 71 · see citing works
The ambiguity of physical activity, exercise and atrial fibrillation
Morseth, B., Løchen, M., Ariansen, I., Myrstad, M., & Thelle, D. S. (2018) · European Journal of Preventive Cardiology · doi:10.1177/2047487318754930 · Cited by 70 · see citing works
Fabritz, L., Crijns, H. J. G. M., Guasch, E., Goette, A., Häusler, K. G., Kotecha, D., Lewalter, T., Meyer, C. G., Potpara, T., Rienstra, M., et al. (2020) · EP Europace · doi:10.1093/europace/euaa279 · Cited by 69 · see citing works
Self-citationVagal atrial fibrillation: What is it and should we treat it?
Carpenter, A., Frontera, A., Bond, R., Duncan, E., & Thomas, G. (2015) · International Journal of Cardiology · doi:10.1016/j.ijcard.2015.08.108 · Cited by 65 · see citing works
Exercise and Atrial Fibrillation: Prevention or Causation?
Elliott, A. D., Linz, D., Verdicchio, C. V., & Sanders, P. (2018) · Heart Lung and Circulation · doi:10.1016/j.hlc.2018.04.296 · Cited by 63 · see citing works
Elliott, A. D., Maatman, B. T., Emery, M. S., & Sanders, P. (2017) · Heart Rhythm · doi:10.1016/j.hrthm.2017.07.001 · Cited by 62 · see citing works
Age as a Critical Determinant of Atrial Fibrillation: A Two-sided Relationship
Laredo, M., Waldmann, V., Khairy, P., & Nattel, S. (2018) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2018.08.007 · Cited by 63 · see citing works
Self-citationWhat do we know about the cardiac benefits of exercise?
Wei, X., Liu, X., & Rosenzweig, A. (2014) · Trends in Cardiovascular Medicine · doi:10.1016/j.tcm.2014.12.014 · Cited by 59 · see citing works
Bei, Y., Wang, L., Ding, R., Che, L., Fan, Z., Gao, W. D., Liang, Q., Lin, S., Liu, S., Lu, X. J., et al. (2021) · Journal of sport and health science/Journal of Sport and Health Science · doi:10.1016/j.jshs.2021.08.002 · Cited by 60 · see citing works
Imaging assessment of the right atrium: anatomy and function
Lang, R. M., Cameli, M., Sade, L. E., Faletra, F. F., Fortuni, F., Rossi, A., & Soulat-Dufour, L. (2022) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jeac011 · Cited by 57 · see citing works
Ramos, P., Rubies, C., Torres, M., Batlle, M., Farré, R., Brugada, J., Montserrat, J. M., Almendros, I., & Mont, L. (2014) · Respiratory Research · doi:10.1186/1465-9921-15-54 · Cited by 57 · see citing works
Self-citationThe Impact of Diet and Lifestyle on Atrial Fibrillation
Nalliah, C. J., Sanders, P., & Kalman, J. M. (2018) · Current Cardiology Reports · doi:10.1007/s11886-018-1082-8 · Cited by 57 · see citing works
Atrial Fibrillation in Athletes
Estes, N. A. M., & Madias, C. (2017) · JACC: Clinical Electrophysiology · doi:10.1016/j.jacep.2017.03.019 · Cited by 56 · see citing works
Brugger, N., Krause, R., Carlen, F., Rimensberger, C., Hille, R., Steck, H., Wilhelm, M., & Seiler, C. A. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2013.11.032 · Cited by 54 · see citing works
D’Ascenzi, F., Pelliccia, A., Natali, B. M., Cameli, M., Andrei, V., Incampo, E., Alvino, F., Lisi, M., Padeletti, M., Focardi, M., et al. (2015) · International journal of cardiac imaging · doi:10.1007/s10554-015-0600-7 · Cited by 52 · see citing works
Heidbüchel, H., Adami, P. E., Antz, M., Braunschweig, F., Delise, P., Scherr, D., Solberg, E. E., Wilhelm, M., & Pelliccia, A. (2020) · European Journal of Preventive Cardiology · doi:10.1177/2047487320925635 · Cited by 53 · see citing works
Acute, Exercise Dose-Dependent Impairment in Atrial Performance During an Endurance Race
la Garza, M. S., Grazioli, G., Bijnens, B. H., Sarvari, S. I., Guasch, E., Pajuelo, C., Brotons, D., Subirats, E., Brugada, R., Roca, E., et al. (2016) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2016.03.016 · Cited by 49 · see citing works
Self-citationA systematic comparison of exercise training protocols on animal models of cardiovascular capacity
Feng, R., Wang, L., Li, Z., Yang, R., Yu, L., Sun, Y., Yu, Q., Ghartey‐Kwansah, G., Sun, Y., Wu, Y., et al. (2018) · Life Sciences · doi:10.1016/j.lfs.2018.12.001 · Cited by 49 · see citing works
Miao, R., Lu, Y., Xing, X., Li, Y., Huang, Z., Zhong, H., Huang, Y., Chen, A. F., Tang, X., Li, H., et al. (2015) · Hypertension · doi:10.1161/hypertensionaha.115.05957 · Cited by 47 · see citing works
Intrinsic Electrical Remodeling Underlies Atrioventricular Block in Athletes
Mesirca, P., Nakao, S., Nissen, S. D., Forte, G., Anderson, C., Trussell, T., Li, J., Cox, C., Zi, M., Logantha, S. J. R. J., et al. (2021) · Circulation Research · doi:10.1161/circresaha.119.316386 · Cited by 50 · see citing works
Endurance Exercise and the Heart: Friend or Foe?
Sanchis‐Gomar, F., Pérez, L. M., Joyner, M. J., Löllgen, H., & Lucía, A. (2015) · Sports Medicine · doi:10.1007/s40279-015-0434-4 · Cited by 44 · see citing works
Elliott, A. D., Mahajan, R., Linz, D., Stokes, M. B., Verdicchio, C. V., Middeldorp, M. E., Gerche, A. L., Lau, D. H., & Sanders, P. (2018) · Clinical Cardiology · doi:10.1002/clc.22967 · Cited by 43 · see citing works
The counterintuitive role of exercise in the prevention and cause of atrial fibrillation
Buckley, B. J. R., Lip, G. Y. H., & Thijssen, D. H. J. (2020) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00509.2020 · Cited by 42 · see citing works
Atrial function is altered in lone paroxysmal atrial fibrillation in male endurance veteran athletes
Hubert, A., Galand, V., Donal, E., Pavin, D., Galli, E., Martins, R. P., Leclercq, C., Carré, F., & Schnell, F. (2017) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jex225 · Cited by 42 · see citing works
Mechanisms of atrial fibrillation in athletes: what we know and what we do not know
Guasch, E., Mont, L., & Sitges, M. (2018) · Netherlands Heart Journal · doi:10.1007/s12471-018-1080-x · Cited by 43 · see citing works
Self-citationThomas, D., Christ, T., Fabritz, L., Goette, A., Hammwöhner, M., Heijman, J., Kockskämper, J., Linz, D., Odening, K. E., Schweizer, P. A., et al. (2018) · Clinical Research in Cardiology · doi:10.1007/s00392-018-1377-1 · Cited by 40 · see citing works
la Garza, M. S., Rubies, C., Batlle, M., Bijnens, B. H., Mont, L., Sitges, M., & Guasch, E. (2017) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00763.2016 · Cited by 38 · see citing works
Self-citationMasked hypertension and cardiac remodeling in middle-aged endurance athletes
Trachsel, L. D., Carlen, F., Brugger, N., Seiler, C. A., & Wilhelm, M. (2015) · Journal of Hypertension · doi:10.1097/hjh.0000000000000558 · Cited by 37 · see citing works
Fu, Y., Jiang, T., Sun, H., Li, T., Gao, F., Fan, B., Li, X., Qin, X., & Zheng, Q. (2021) · Journal of Cellular and Molecular Medicine · doi:10.1111/jcmm.16796 · Cited by 37 · see citing works
Exercise Training: The Holistic Approach in Cardiovascular Prevention
Giallauria, F., Strisciuglio, T., Cuomo, G., Lorenzo, A. D., D’Angelo, A., Volpicelli, M., Izzo, R., Manzi, M. V., Barbato, E., & Morisco, C. (2021) · High Blood Pressure & Cardiovascular Prevention · doi:10.1007/s40292-021-00482-6 · Cited by 35 · see citing works
Atrial Fibrillation (AF) in Endurance Athletes: a Complicated Affair
Stergiou, D. V., & Duncan, E. R. (2018) · Current Treatment Options in Cardiovascular Medicine · doi:10.1007/s11936-018-0697-9 · Cited by 35 · see citing works
Letnes, J. M., Nes, B. M., Vaardal‐Lunde, K., Slette, M. B., Molmen, H. E., Aspenes, S. T., Støylen, A., Wisløff, U., & Dalen, H. (2020) · Journal of the American Heart Association · doi:10.1161/jaha.119.014682 · Cited by 34 · see citing works
Guseh, J. S., Churchill, T. W., Yeri, A., Lo, C. T., Brown, M. G., Houstis, N. E., Aragam, K. G., Lieberman, D. E., Rosenzweig, A., & Baggish, A. L. (2020) · Scientific Reports · doi:10.1038/s41598-020-67669-0 · Cited by 33 · see citing works
Risk Factors for Atrial Fibrillation Progression
Heijman, J., LUERMANS, J. G. L. M., Linz, D., Gelder, I. C. V., & Crijns, H. J. G. M. (2021) · Cardiac Electrophysiology Clinics · doi:10.1016/j.ccep.2020.10.011 · Cited by 35 · see citing works
Incidence, recurrence, and outcome of postrace atrial fibrillation in Thoroughbred horses
Nath, L. C., Elliott, A. D., Weir, J., Curl, P., Rosanowski, S. M., & Franklin, S. H. (2021) · Journal of Veterinary Internal Medicine · doi:10.1111/jvim.16063 · Cited by 35 · see citing works
Autoimmune Atrial Fibrillation
Maguy, A., Mahendran, Y., Tardif, J., Busseuil, D., & Li, J. (2023) · Circulation · doi:10.1161/circulationaha.122.062776 · Cited by 34 · see citing works
Self-citationAtrial Fibrillation: Mechanisms, Therapeutics, and Future Directions
Pellman, J., & Sheikh, F. (2015) · Comprehensive physiology · doi:10.1002/j.2040-4603.2015.tb00626.x · Cited by 34 · see citing works
Zhu, W., Wan, R., Din, Y., Xu, Z., Yang, X., & Hong, K. (2016) · Clinical Cardiology · doi:10.1002/clc.22531 · Cited by 34 · see citing works
Dolinsky, V. W., & Dyck, J. R. B. (2014) · Molecules · doi:10.3390/molecules190914919 · Cited by 34 · see citing works
Outcomes of Pulmonary Vein Isolation in Athletes
Mandsager, K. T., Phelan, D. M. J., Diab, M., Baranowski, B. J., Saliba, W. I., Tarakji, K. G., Jaber, W. A., Kanj, M. H., TCHOU, P. J., Lindsay, B. D., et al. (2020) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2020.05.009 · Cited by 35 · see citing works
Sutanto, H., Laudy, L., Clerx, M., Dobrev, D., Crijns, H. J. G. M., & Heijman, J. (2019) · Pharmacological Research · doi:10.1016/j.phrs.2019.104444 · Cited by 33 · see citing works
Self-citationAyinde, H., Schweizer, M. L., Crabb, V., Ayinde, A., Abugroun, A., & Hopson, J. (2018) · IJC Heart & Vasculature · doi:10.1016/j.ijcha.2018.01.002 · Cited by 32 · see citing works
Risk Factors and Genetics of Atrial Fibrillation
ANUMONWO, J. M. B., & Kalifa, J. (2014) · Cardiology Clinics · doi:10.1016/j.ccl.2014.07.007 · Cited by 32 · see citing works
Left Atrial Enlargement in Young High-Level Endurance Athletes – Another Sign of Athlete’s Heart?
Król, W., Jędrzejewska, I., Konopka, M. A., Burkhard-Jagodzińska, K., Klusiewicz, A., Pokrywka, A., Chwalbińska, J., Sitkowski, D., Dłużniewski, M., Mamcarz, A., et al. (2016) · Journal of Human Kinetics · doi:10.1515/hukin-2016-0012 · Cited by 32 · see citing works
Atrial arrhythmias and autonomic dysfunction in rats exposed to chronic intermittent hypoxia
Bober, S. L., Ciriello, J., & Jones, D. L. (2018) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00173.2017 · Cited by 33 · see citing works
Risk Factors and Genetics of Atrial Fibrillation
ANUMONWO, J. M. B., & Kalifa, J. (2016) · Heart Failure Clinics · doi:10.1016/j.hfc.2015.08.013 · Cited by 31 · see citing works
Opel, A., Nobles, M., Montaigne, D., Finlay, M., Anderson, N., Breckenridge, R. A., & Tinker, A. (2015) · Journal of Biological Chemistry · doi:10.1074/jbc.m115.666719 · Cited by 31 · see citing works
Lakin, R., Polidovitch, N., Yang, S., Guzman, C., Gao, X., Wauchop, M., Burns, J., Izaddoustdar, F., & Backx, P. H. (2019) · Journal of Molecular and Cellular Cardiology · doi:10.1016/j.yjmcc.2019.01.012 · Cited by 31 · see citing works
Woodard, G. E., Jardín, I., Berna‐Erro, A., Salido, G. M., & Rosado, J. A. (2015) · International review of cytology · doi:10.1016/bs.ircmb.2015.02.001 · Cited by 30 · see citing works
Stewart, G. M., Chan, J. H., Yamada, A., Kavanagh, J. J., Haseler, L. J., Shiino, K., & Sabapathy, S. (2016) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jew128 · Cited by 30 · see citing works
Atrial Fibrillation in Endurance Athletes
Elliott, A. D., Mahajan, R., Lau, D. H., & Sanders, P. (2016) · Cardiology Clinics · doi:10.1016/j.ccl.2016.06.006 · Cited by 30 · see citing works
Lakin, R., Guzman, C., Izaddoustdar, F., Polidovitch, N., Goodman, J. M., & Backx, P. H. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.00841 · Cited by 30 · see citing works
Atrial fibrillation: Neurogenic or myogenic?
Scridon, A., Şerban, R. C., & Chevalier, P. (2017) · Archives of cardiovascular diseases · doi:10.1016/j.acvd.2017.11.001 · Cited by 29 · see citing works
Cardiovascular Care of Masters Athletes
Churchill, T. W., & Baggish, A. L. (2020) · Journal of Cardiovascular Translational Research · doi:10.1007/s12265-020-09987-2 · Cited by 29 · see citing works
Increased Flow, Dam Walls, and Upstream Pressure
Gerche, A. L., & Claessen, G. (2016) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2016.06.008 · Cited by 29 · see citing works
Scar-based catheter ablation for persistent atrial fibrillation
Nery, P. B., Thornhill, R. E., Nair, G. M., Peña, E., & Redpath, C. J. (2016) · Current Opinion in Cardiology · doi:10.1097/hco.0000000000000349 · Cited by 28 · see citing works
Electrocardiographic characteristics of trained and untrained standardbred racehorses
Nissen, S. D., Weis, R., Krag‐Andersen, E. K., Hesselkilde, E. M., Isaksen, J. L., Carstensen, H., Kanters, J. K., Linz, D., Sanders, P., Hopster-Iversen, C. C. S., et al. (2022) · Journal of Veterinary Internal Medicine · doi:10.1111/jvim.16427 · Cited by 28 · see citing works
Exercise and Arrhythmias: A Double‐Edged Sword
Manolis, A. S., & MANOLIS, A. A. (2016) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.12879 · Cited by 27 · see citing works
- Authors
- Guasch, E., Benito, B., Qi, X., Cifelli, C., Naud, P., Shi, Y., Mighiu, A., Tardif, J.-C., Tadevosyan, A., Chen, Y., Gillis, M.-A., Iwasaki, Y.-K., Dobrev, D., Mont, L., Heximer, S., & Nattel, S.
- Affiliations
- Montreal Heart Institute (CA)
- University of Toronto (CA)
- University of Duisburg-Essen (DE)
- Corresponding author
- Nattel, Stanley
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2013-07
- Volume
- 62
- Issue
- 1
- Pages
- 68-77
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W199998949
- Cited by
- 302
- References
- 33
- Citations by year
- 2026: 16 · 2025: 15 · 2024: 26 · 2023: 25 · 2022: 16 · 2021: 29 · 2020: 28 · 2019: 20 · 2018: 31 · 2017: 18 · 2016: 24 · 2015: 23 · 2014: 19 · 2013: 11
- FWCI
- 17.53
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Universitätsbibliographie, Universität Duisburg-Essen (submittedVersion)
- Funders
- Canadian Institutes of Health Research (MGP-6957, MOP44365, MOP106670)
- Quebec Heart and Stroke Foundation
- Fondation Leducq
- Deutsche Forschungsgemeinschaft
- Spanish Health Ministry (CM08/00201, CM06/00189)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Keywords
- atrial fibrillation, endurance exercise, exercise training, atrial remodeling, atrial dilatation, atrial fibrosis, parasympathetic activity, vagal tone, baroreflex, RGS4, atrial fibrillation risk, detraining, atrial electrophysiology
- MeSH terms
- Animals, Atrial Fibrillation, Disease Models, Animal, Exercise Test, Mice, Inbred C57BL, Physical Conditioning, Animal, Physical Endurance, Random Allocation, Rats, Wistar, Mice, Knockout, Mice, Rats
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