Participants in the 1990 Barcelona marathons were invited to participate in a health survey (unrelated to the topic of atrial fibrillation). A total of 252 runners agreed. Age range at entry was 20-60. Of these, 183 agreed to participate in a follow-up examination in 2002-03, on average 11 years after the initial marathon.
The controls were selected from a near contemporaneous, unrelated study of 802 subjects (age range 25-74) performed in the Barcelona region. All subjects who were sedentary (< 305 kcal/day of leisure activity) were selected. That made up a group of 305 subjects. Of these, 290 agreed to respond at the 2003-03 follow-up. The study design is below:
Despite being younger and leaner than the control group, the group of marathoners had a higher rate of atrial fibrillation (prevalence ~ 5% among marathon runners). Note: consumption of alcohol was greater among marathon runners…
The authors then compared the marathon runners with AF compared to those without AF. There was no identifiable clinical or echocardiographic difference at the baseline visit. At the follow-up visit, LA dimension was greater in the fibbers (chicken or egg?).
The data tables are below.
Main take-home lesson: the study solidifies the increased risk of AF in athletes. Still no distinguishing predictive baseline characteristics and no real handle on whether any monitoring can identify athletes on the verge of developing significant AF (the paper by Furlanello et al. suggested AF could be reversed if caught early and activity level is decreased)
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