Atrial Fibrillation in Athletes: What You Need to Know

Allison Bush | Jan 29th 2014

Reviewed by Glenn Gandelman, M.D., M.P.H.

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Who is affected?

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Men, especially with a history of participating in endurance sports. According to a study published in the European Heart Journal, 10 percent of former Swiss professional cyclists had developed atrial fibrillation at the average age of 66 years. Another stat shows that AFib is up to five times more common in endurance athletes than in the general population.

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Why does this happen?

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Endurance athletes and competitive power sport athletes tend to have increased heart muscle mass. Other contributing AFib factors common in athletes include increased vagal tone (slower heart beat), fibrosis, and heart chamber enlargement.

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Does AFib treatment differ for athletes?

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In short, no. First and foremost, make sure to eliminate any triggers, like caffeine and alcohol. Second, make sure you’re getting a good night’s sleep. Next, you can decide whether or not to treat your AFib. If flares are infrequent, you don’t necessarily have to treat it. If you do choose to treat it, antiarrhythmic medication is typically the first line of treatment, then ablation.

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What are the risks?

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Despite the associated risks, life expectancy is generally prolonged in endurance athletes. However, there are risks associated with treatment choices. If an athlete decides to take medication, it may affect performance or it may not completely treat symptoms. It is also unknown how these medications work with extreme athletes. Ablation, which may be more successful, is also quite invasive.

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Do you need to stop exercising?

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Management focuses on control of AFib as well as consideration for restriction based on the specific sport, the level of competition, and the symptoms. Some athletes may remain asymptomatic without medications, have short episodes, or an isolated episode (even if it requires cardioversion). For those with recurrent and highly symptomatic episodes, sport restriction may be necessary.

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Watch for symptoms

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If you’re exercising and you feel extreme breathlessness and/or exhaustion, stop immediately and speak with a health professional before your next attempt at exercising.

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Check your pulse

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Make sure to ask your doctor what your heart rate should be while you’re exercising and when you’re resting. Then, ask for recommendations on what to do if your pulse is too low or too high.

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Try interval workouts

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Sometimes, people with AFib experience a decrease in exercise endurance. With interval training, however, you can warm up your body, and then push yourself to a point where you’re slightly exceeding your limit, and then recover. This cycle can be repeated several times until your workout is complete.

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Protect your body

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If you have AFib you’re most likely on a blood-thinning medication, so it’s important for you to protect your body from any injury that may cause blood loss. If you’re biking, be sure to wear a helmet, and always be careful when you’re around heavy weights.

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Be careful with hydration

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With AFib, you may have restrictions on how much liquid you should consume, due to a weakened or stiff heart muscle. Be sure to speak with your doctor to find out if you have any fluid restrictions before engaging in strenuous exercise.