This study is from the same Barcelona group that published the Mont et al. paper. In fact, the patients presented are exactly the same 51 male patients with lone atrial fibrillation identified from the outpatient arrhythmia center database, and the controls were also taken from the same cohort of subjects. In this study, however, the investigators age-matched 2 control subjects for each AF patient and administered a sport activity questionnaire to all of them.
The questions were as follows:
An interviewer administered a questionnaire about current and former sport practice to cases and controls. The following questions were included: a) ‘‘Have you ever practiced a sport regularly?’’ All participants who reported a practice of more than or two sessions per week totalling more than 2 h per week were considered as regular sport practitioners; b) ‘‘Which sports have you practiced?’’ Sports were classified as mainly aerobic or non-aerobic. Those sports that use a large muscle mass, are rhythmic, continuous and usually sustained for a long period of time were considered as mainly aerobic. Examples of this type of sports are swimming, cycling, soccer, etc.; c) Please indicate the age of beginning and ending the practice of each sport, and average number of hours of practice per week. According to the number of years of sport practice and the number of hours of practice per week, the lifetime number of hours of sport practice was calculated. Among those reporting sport practice, those practicing sport at the time of the study were considered current practitioners and the rest former practitioners.
The results are here:
Click to enlarge
Click to enlarge
In other words, no statistically significant differences between AF and control groups in terms of proportion of subjects reporting current or former sporting activity, years of practice, years since cessation, lifetime hours of sport. The only difference is that more LAF patients reported on-going sport activity than controls. The authors also state (guardedly) that a 1500 lifetime hours of sport may be a threshold for increasing risk of AF (see table 3).
My comments: not a very edifying report. Retrospective questionnaires are fraught with problems and by necessity must be very general. There was no way to assess the intensity of sport activity. The numbers of cases is small. We really can’t hang our hat on the 1500 lifetime hours number they came up with.
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I agree the 1500 “threshold” lifetime number is not well supported. Of course,I don’t want to believe the “threshold” (if there is one) is that low. I have logged that many hours jogging every 4 years or so for the past 35 years. I would be very interested in your thoughts on the existence of a chronic endurance-exercise cardiomyopathy.
James
Hi James,
I haven’t gotten to the papers that look at RV and fibrosis yet, but that will come when we hit 2009 and later. There have been a few reports of increased ventricular arrhythmias since the 1990′s which I will get into, perhaps after we cover the AFib series. The report could suggest some problem at the myocardial level. Look for the discussion on the Tour de Suisse athletes, coming up shortly. I think that’s an important paper where they comment both on AF and ventricular arrhythmias.
Michel