CoChat
Sign Up
Cited by 110Cardiovascular Effects of ExerciseAtrial Fibrillation Management and OutcomesCardiovascular and Diving-Related Complications

Risk of atrial fibrillation in athletes: a systematic review and meta-analysis

Open access
Newman, William, Parry-Williams, Gemma, Wiles, Jonathan, Edwards, Jamie, Hulbert, Sabina, Kipourou, Konstantina, Papadakis, Michael, Sharma, Rajan +1 more·2021·British Journal of Sports Medicine
DOI 10.1136/bjsports-2021-103994
Open this paper in CoChat — free accountOpen PDF

Abstract

OBJECTIVE: A systematic review, meta-analysis and meta-regression were performed on selected studies to investigate the incidence of atrial fibrillation (AF) among athletes compared with non-athlete controls. DESIGN: Meta-analysis with heterogeneity analysis and subsequent meta-regression to model covariates were performed. The mode of exercise (endurance and mixed sports) and age were the a priori determined covariates. DATA SOURCES: PubMed, MEDLINE, Science Direct, SPORTDiscus and the Cochrane library were searched. ELIGIBILITY CRITERIA: Research articles published after 1990 and before 2 December 2020 were included if they reported the number of AF cases in athletes with non-athlete (physically active or inactive) control groups, were case-control or cohort studies and if data allowed calculation of OR. RESULTS: The risk of developing AF was significantly higher in athletes than in non-athlete controls (OR: 2.46; 95% CI 1.73 to 3.51; p<0.001, Z=4.97). Mode of exercise and risk of AF were moderately correlated (B=0.1259, p=0.0193), with mixed sport conferring a greater risk of AF than endurance sport (B=-0.5476, p=0.0204). Younger (<55 years) athletes were significantly more likely to develop AF compared with older (≥55 years) athletes (B=-0.02293, p<0.001). CONCLUSION: Athletes have a significantly greater likelihood of developing AF compared with non-athlete controls, with those participating in mixed sport and younger athletes at the greatest risk. Future studies of AF prevalence in athletes according to specific exercise dose parameters, including training and competition history, may aid further in delineating those at risk.

Integrity signals

Registry

Crossref · 10.1136/bjsports-2021-103994

Cites

51 of 52 references verified0 citation errors · 1 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

11 of 24 cited sources checked · 5 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    In general, the risk of atrial fibrillation in female athletes appears to be lower than in male athletes.

    “In general, risk of AF in female athletes appears to be lower than in male athletes.29 38”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [29] source
    • cites [38] Svedberg, 2019, Long-Term incidence of atrial fibrillation and stroke among Cross-Country skiers, Circulation source
  • Findingown data

    Younger athletes had a significantly higher relative risk of atrial fibrillation than older athletes (younger OR 3.60; 95% CI 2.09 to 6.29, p<0.001, Z=4.603; older OR 1.76; 95% CI 0.97 to 3.21, p=0.065, Z=1.845).

    “Younger athletes (OR: 3.60; 95% CI 2.09 to 6.29, p<0.001,Z=4.603) had a significantly higher relative risk of AF than older athletes (OR: 1.76; 95% CI 0.97 to 3.21, p=0.065,Z=1.845) (figure 3)”
    Quote in the paperNot a substantial claim
  • Findingown data

    In athletes and non-athletes without cardiovascular disease risk factors, athletes had a significantly greater relative risk of atrial fibrillation (OR 3.66; 95% CI 2.28 to 5.88, p<0.001, Z=5.355).

    “However, in athletes and non-athletes without CVD risk factors, athletes had a significantly greater relative risk of AF (OR: 3.66; 95% CI 2.28 to 5.88, p<0.001,Z=5.355).”
    • Also stated in: § Review · plain
      “When CVD was excluded from analyses, the risk of AF in athletes was significantly greater compared with non-athletes (OR: 3.66).”
    Quote in the paperSubstantial claim
  • Findingown data

    There was a significant relationship between the mode of exercise and risk of atrial fibrillation (B=0.1259, p=0.0193).

    “There was a significant relationship between the mode of exercise and risk of AF (B=0.1259,p=0.0193), with mixed sport conferring a greater risk of AF compared with endurance sport (B=-0.5476,p=0.0204).”
    Quote in the paperSubstantial claim
  • Findingown data

    The risk of atrial fibrillation was significantly higher in athletes than non-athletes (OR 2.46; 95% CI 1.73 to 3.51, p<0.001, Z=4.97).

    “The initial random effects pooled analysis demonstrated that the risk of AF was significantly higher in athletes than nonathletes (OR: 2.46; 95% CI 1.73 to 3.51, p<0.001,Z=4.97) (figure 2).”
    • Also stated in: § DISCUSSION · hedged
      “The results of the analysis indicate that the relative risk of AF is higher in athletes than in those not exercising or performing regular, non-competitive physical activity.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The prevalence of atrial fibrillation among athletes is relatively low.
    • Rests on an assumption: Atrial flutter is a precursor to atrial fibrillation.
  • May combine two claims. 18
  • Classified as probably not a substantial claim. 16
  • The quote only partly states this claim. 1

  • May combine two claims.

    Premisecitation

    Two prior meta-analyses investigating the possible increased risk of atrial fibrillation in athletes demonstrated equivocal findings, with odds ratios of 1.64 and 5.29.

    “Two prior meta-analyses investigating the possible increased risk of AF in athletes have demonstrated equivocal findings, with ORs of 1.64 14 and 5.29.15”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [14] source
    • cites [15] Ayinde, 2018, Age modifies the risk of atrial fibrillation among athletes: a systematic literature review and meta-analysis, Int J Cardiol Heart Vasc source

  • Classified as probably not a substantial claim.

    Premisecitation

    Male endurance athletes performing high-intensity and high-volume exercise training are at increased risk of atrial fibrillation.

    “It has been reported that male endurance athletes performing high-intensity and high-volume exercise training are at an increased risk, 9”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [9] source

      The Abstract reports a higher risk of symptomatic lone atrial fibrillation in male marathon runners than in sedentary men. The Discussion (Figure 2 section; page unavailable) indicates substantial lifetime sport practice among the runners, but the paper does not establish that high training intensity specifically increases risk; its finding is also narrower than atrial fibrillation generally. (LLM, conf=0.83)

      Experimental — accuracy not yet measured

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Lack of physical activity and long-term vigorous exercise both increase the risk of developing atrial fibrillation, suggesting a U-shaped curve.

    “with studies suggesting a U-shaped curve, with lack of physical activity and long-term vigourous exercise both increasing the risk of developing AF. 10 11”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [10] source
    • cites [11] source

      The Introduction reports reduced AF risk with moderate activity and increased risk with high-intensity or endurance exercise in younger athletes and middle-aged men, supporting the suggested curve for those groups. The Results (Physical activity and AF) found that activity above 1,000 MET-minutes/week was not associated with higher risk than inactivity, so this paper does not establish increased risk at both extremes in the general population. Page numbers were not supplied in our copy. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Ayinde et al identified age as a significant determinant of atrial fibrillation risk, with younger athletes below 40 years old at greater relative risk than athletes over 54 years of age.

    “Interestingly, Ayinde et al 15 identified age as a significant determinant of AF risk, with younger athletes (below 40 years old) at greater relative risk than athletes >54 years of age.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [15] Ayinde, 2018, Age modifies the risk of atrial fibrillation among athletes: a systematic literature review and meta-analysis, Int J Cardiol Heart Vasc source

      The Results (Stratified analysis > Age) identify age as an effect modifier: athletes under 54 had significantly higher odds of AF than similarly aged controls, while the increase was not significant among athletes 54 or older. The paper uses a cutoff of 54, not 40, and compares each athlete age group with controls rather than directly comparing younger and older athletes. (LLM, conf=0.90)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Hoogsteen et al discuss atrial fibrillation being triggered by adrenergic surges during exercise in younger athletes, whereas older athletes typically experience vagally induced atrial fibrillation after exercise, normally from secondary autonomic dysfunction.

    “Investigating the mechanistic underpinning of this age-dependant risk, Hoogsteen et al 24 discuss AF being triggered by adrenergic surges occurring during exercise in younger athletes, 25 whereas older athletes typically experience vagally induced AF after exercise, normally from secondary autonomic dysfunction.26”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites [24] Hoogsteen, 2004, Recommendations and cardiological evaluation of athletes with arrhythmias: Part 1, Neth Heart J

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites [25] source

      Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites [26] source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Wilhelm indicates biatrial remodelling, dilation and fibrosis as crucial substrates to developing atrial fibrillation.

    “Mechanistically, Wilhelm 13 indicates biatrial remodelling, dilation and fibrosis as crucial substrates to developing this pathology.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [13] source

      In “The substrate: atrial remodelling in athletes” (page unavailable), Wilhelm reports enlargement of both atria in endurance athletes and says enlargement accompanied by fibrosis in aging athletes may create a substrate for atrial fibrillation. Calling remodelling, dilation and fibrosis unqualified “crucial substrates” overstates that tentative, age-dependent account; the section also notes that enlarged atria in young athletes did not necessarily increase AF risk. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Study design and conductcitation

    The pooled OR estimates of this analysis may be limited by sparse data bias, which can inflate estimates of effect measures and should be considered when interpreting the findings.

    “This analysis may also be limited by the possibility of sparse data bias in the pooled OR estimates, as indicated by the unconventional ORs and wide confidence limits produced by some studies.This is problematic as such bias can inflate the estimate of effect measures, which should be taken into account when interpreting the findings of the present analysis.37”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [37] Greenland S , Mansournia MA , Altman DG . Sparse data bias: a problem hiding in plain sight. BMJ;2016:i1981. doi:10.1136/bmj.i1981 source

  • May combine two claims.

    Findingown data

    Only two included studies provided data on exercise volume or average duration, both defined by lifetime exercise hours, and these could not be used to quantify weekly exposure.

    “Only two studies provided data on volume or average duration of exercise and both defined this by lifetime exercise hours and could therefore not be used to quantify weekly exposure.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of the endurance sports, cycling conferred the highest risk of atrial fibrillation and Nordic skiing conferred the lowest risk.

    “Of the endurance sports, cycling conferred the highest risk of AF and Nordic skiing conferred the lowest risk (see online supplemental figure S3 for the lowest to highest risk of AF in endurance sports).”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    Mixed sport conferred a greater risk of atrial fibrillation compared with endurance sport (B=-0.5476, p=0.0204).

    “Crucially, our research identifies a significant relationship between mode of exercise and risk of developing AF, with mixed sport conferring a greater risk than endurance sport.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Five included studies included athletes with the cardiovascular disease risk factors diabetes and/or hypertension.

    “Five studies included athletes with the CVD risk factors diabetes and/or hypertension.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The meta-analysis included 13 studies (7 cohort and 6 case-control) with a pooled sample size of 70,478 participants, including 63,662 controls and 6,816 athletes.

    “The meta-analysis included 13 studies (7 cohort and 6 case-control) with a pooled sample size of 70 478 participants, which included 63 662 controls and 6816 athletes (online supplemental file).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Atrial flutter is a precursor to atrial fibrillation.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    It was not possible to appropriately analyse the association of exercise intensity and atrial fibrillation risk due to insufficient data.

    “However, it was not possible to appropriately analyse the association of exercise intensity and AF risk due to insufficient data.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Egger's test was statistically significant (p<0.001), suggesting publication bias.

    “The post hoc Egger's test (1997) was statistically significant (p<0.001),suggesting publication bias.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Three included studies involved Nordic skiing, representing 36% of the total weighting in the overall effect size.

    “Of the studies included in the analysis, three involved Nordic skiing, with these studies representing 36% of the total weighting in the overall effect size.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Study data extraction and risk of bias analysis were systematically screened by a second reviewer, and disputes were resolved by discussion.

    “Study data was extracted and a risk of bias analysis performed, which were systematically screened by a second reviewer.When disputes were detected in coding or quality analyses, the reviewers met to discuss any conflicts, which were then resolved and evaluated further.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    This systematic review and meta-analysis was fully compliant with and performed according to PRISMA guidelines, including use of the PICOS method.

    “This systematic review and meta-analysis was fully compliant with and performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 16 including use of the described PICOS method for the systematic review process.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Qualitative risk of bias assessment was carried out independently for cohort and case-control studies using the CLARITY tool from McMaster University.

    “Qualitative risk of bias assessment was carried out utilising the tool from CLARITY at McMaster University (Evidence Partners, 2019) to ascertain the risk of bias in the cohort and case-control studies independently.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    Inclusion of studies involving athlete cohorts with common health conditions offers a more real-world estimation.

    “Additionally, the inclusion of studies involving athlete cohorts with common health conditions offers a more 'real world' estimation.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The observation that endurance sports correlate with atrial fibrillation is generally accepted.

    “Indeed, the observation that endurance sports correlate with AF is generally accepted.21”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] source

  • May combine two claims.

    Interpretationown data

    The odds ratio in older athletes was still 1.76 and much higher compared with non-athletes, and thus must not be ignored.

    “However, the OR in older athletes was still 1.76 and much higher compared with non-athletes and thus must not be ignored.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    It cannot be excluded that the remaining endurance sports included were comparatively underestimated in the analysis, with Nordic skiing over-represented due to a greater quantity of published studies.

    “With this, it cannot be excluded that the remaining endurance sports included were comparatively underestimated in the analysis with Nordic skiing over-represented due to a greater quantity of published studies.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given

    Prior research suggests there is a threshold beyond which exposure to increasing levels of exercise is associated with an increased risk of cardiovascular disease, including arrhythmias (a U-shaped relationship).

    “Prior research suggests there is a threshold beyond which exposure to increasing levels of exercise is associated with an increased risk of cardiovascular disease, including arrhythmias (U-shaped relationship).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    The pooled odds ratio of 2.46 is much closer to the true value because the analysis included studies examining athletes, physically active individuals and sedentary populations, unlike other analyses.

    “First, our OR, considering all primary studies, of 2.46 is much closer to the 'true' value as we included studies examining athletes, physically active individuals and sedentary populations, unlike other analyses.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    The observed I2 value of 84% is well above an expected I2 value for a meta-analysis, probably owing to differences in methodological parameters in the included studies.

    “Indeed, 84% is well above an expected I 2 value for a meta-analysis, probably owing to the differences in methodological parameters in the included studies.20”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The lower association of atrial fibrillation in older athletes compared with younger athletes has been previously linked to the higher rates of atrial fibrillation in older individuals, independent from physical activity levels.

    “With this, the lower association of AF in older athletes compared with younger athletes has been previously linked to the higher rates of AF in older individuals, independent from physical activity levels.27”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] source

  • May combine two claims.

    Premisecitation

    Furlanello et al examined the relationship between atrial fibrillation risk and sport participation in elite and Olympic athletes, finding a significant prevalence among young male athletes of average age 24 years.

    “Additionally, Furlanello et al 23 examined the relationship between AF risk and sport participation in elite and Olympic athletes, finding a significant prevalence among young (average age 24 years old), male athletes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Furlanello, 1998, Atrial fibrillation in elite athletes, J Cardiovasc Electrophysiol

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Study design and conductcitation

    The present analysis would have benefited from adjustment using external estimates in those studies which do not apply sufficient adjustment.

    “As detailed in Greenland and O'Rourke, 32 the present analysis would have benefited from adjustment using external estimates in those studies which do not apply sufficient adjustment.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] Greenland S , O’Rourke K . Meta-analysis. In: Rothman KJ , Greenland S , Lash T , eds. Modern epidemiology. 3rd edn. Philadelphia, PA: Lippincott Williams & Wilkins, 2008.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationown data

    It is possible that studies with null hypotheses of a significant relationship between atrial fibrillation and athletes were not published, alongside bias in study methodologies.

    “Indeed, it is possible that studies with a null hypotheses of a significant relationship between AF and athletes were not published, alongside bias in study methodologies.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Because of a lack of available data, this review could not provide information on training volume and the risk of atrial fibrillation.

    “Finally, due to the lack of available data, we were unable to provide information regarding training volume and the risk of AF.”
    Quote in the paperNot a substantial claim
30 of 30

  • The paper relies on this without support.

    The prevalence of atrial fibrillation among athletes is relatively low.

    “As the prevalence is relatively low, this paper aimed to perform a meta-analysis and pool multiple study data to draw a more conclusive overall prevalence among athletes.”

  • The paper relies on this without support.

    Atrial flutter is a precursor to atrial fibrillation.

    “Furthermore, studies reporting atrial flutter were included due to it being a precursor to AF.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In a meta-analysis of 13 studies including approximately 64,000 athletes, athletes were 2.46 times more likely to have prevalent AF (95% CI 1.73 to 3.51), and this odds ratio increased to 3.6 for athletes aged <55 years.

    “A large meta-analysis of 13 studies, including approximately 64,000 athletes, showed that athletes were 2.46 times more likely to have prevalent AF (95% CI 1.73 to 3.51). This odds ratio increased to 3.6 for athletes aged <55 years of age [25].”

    From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [25]

    The Primary analysis reports an AF odds ratio of 2.46 (95% CI 1.73 to 3.51), and the Subgroup analysis reports 3.60 for younger athletes. But Study and participant characteristics says the 13 studies included 70,478 participants—6,816 athletes and 63,662 controls—not approximately 64,000 athletes. The passages found describe the subgroup as ‘younger athletes’ without establishing the claimed <55-year cutoff. (LLM, conf=0.92)

    Experimental — accuracy not yet measured

  • The prevalence of AF in competitive athletes ranges from 0.3% to approximately 13%, differing according to age and modality of exercise training.

    “The prevalence of AF in competitive athletes ranges from 0.3% to approximately 13%, and differs according to the age and the modality of exercise training [13,25,26,27].”

    From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [25]

    The Subgroup analysis (page unavailable) reports different relative AF risks for younger and older athletes, and the Discussion (page unavailable) reports a relationship between exercise mode and AF risk. Neither section reports the claimed prevalence range of 0.3% to approximately 13%; searches for both figures found no supporting passage in our copy. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Athletes participating in mixed sports have increased AF burden compared to those engaged in endurance sports (B = −0.5476, p = 0.0204).

    “Athletes participating in mixed sports (such as football, basketball, and American football) have increased AF burden compared to those engaged in endurance sports (such as Nordic skiing, orienteering, and rowing; B = −0.5476, p = 0.0204) [25].”

    From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [25]

  • Sports participation is associated with incident atrial fibrillation.

    “Although sports participation seems associated with incident AF, 37”

    From Exercise benefits in cardiovascular diseases: From mechanisms to clinical implementation (2023) · cites this paper as [37]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Karjalainen study has conflicting design labels

    Minor

    Table 1 classifies the Karjalainen study as a cohort study, while its title in the paper's reference list identifies it as a case-control study. The distinction matters to the reported analysis by study design.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Greenland S , O’Rourke K . Meta-analysis. In: Rothman KJ , Greenland S , Lash T , eds. Modern epidemiology. 3rd edn. Philadelphia, PA: Lippincott Williams & Wilkins, 2008.

Cited by

Sorted by citations

Related

Authors
Newman, W., Parry-Williams, G., Wiles, J., Edwards, J., Hulbert, S., Kipourou, K., Papadakis, M., Sharma, R., & O'Driscoll, J.
Affiliations
  • Canterbury Christ Church University (GB)
  • Cardiology Clinical Academic Group, St George's University of London, London, UK
  • St George’s University Hospitals NHS Foundation Trust (GB)
  • St George's, University of London (GB)
  • School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
ORCID
Venue
British Journal of Sports Medicine
Publisher
BMJ
Published
2021-07-12
Volume
55
Issue
21
Pages
1233-1238
ISSN
  • 0306-3674 (ISSN-L)
  • 1473-0480
DOI
10.1136/bjsports-2021-103994
OpenAlex
W3180889449
Semantic Scholar
83072963f4ff855873e9eee679f2ad84dca30cc2
Cited by
110
References
45
Citations by year
2026: 14 · 2025: 28 · 2024: 34 · 2023: 23 · 2022: 9 · 2021: 2
FWCI
4.41
Type
journal article
Language
en
Open access
Locations
  • British Journal of Sports Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • St George's Online Research Archive (St George's University of London) (acceptedVersion)
  • Kent Academic Repository (University of Kent) (submittedVersion)
  • UEL Research Repository (University of East London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
Keywords
atrial fibrillation, athletes, sports participation, endurance sports, exercise mode, age, incidence, risk factors
MeSH terms
Adult, Aged, Atrial Fibrillation, Female, Humans, Male, Middle Aged, Sports, Exercise, Incidence, Risk Assessment, Athletes

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-12.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-12.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review