RT-223
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May top-level athletes complain
of atrial fibrillation?
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A. Bertoldi*, F. Furlanello, M.
Dallago*, A. Galassi, F. Fernando**, C. Pappone, S. Chierchia.
S. Raffaele Scientific Institute, Milan-Rome, *Division of Cardiology, S. Chiara Hospital,
Trento, **Sports Science Institute, Italian National Olympic Committee, Rome, Italy
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Abstract
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The prevalence of atrial fibrillation in competitive
athletes (A), particularly at high level of athletic activity, has yet not well been
established.
Here we discuss cases of atrial fibrillation (AF) endangering prosecution of career in
a population of young top-level athletes (TLA). From 1974 to June 1997 1772 arrhythmic
athletes (1464 M, 308 F), mean age 21.6 yrs underwent an individualized
cardioarrhythmological work-up. Among these, 146 (122 M, 24 F) mean age 24.3 yrs were TLA
(including previously National, International, European, World and Olympic Champions)
studied for important arrhythmic manifestations, with mean follow-up of 62.4 months.
13/146 (8.9%) TLA, all males, had AF, persistent permanent in two and paroxysmal in 11. AF
was the cause of symptoms in 40% of TLA with long lasting palpitations. Five TLA had a
previously non documented substrate of AC:\WWW WPW in 3, ARVD in one, healed myocarditis in 1.
In eight TLA AF was considered idiopathic. All TLA are alive with mean follow-up of 82
months, 7 continuing in their specific sport (3 after RFCA: of WPW in two and of AF with
maze NF approach in one).
AF in young TLA affected only males and is one of the most frequent causes of
prolonged palpitations, easily reinduced by transesophageal atrial pacing or
electrophysiologic testing, due to adrenergic or vagal mechanisms. AF may be a cause of
non eligibility but may disappear if the athletic activity is stopped for an adequate
period of time or if trigger mechanisms are corrected (ie WPW, RT) or if the arrhythmic
substrate is modified.
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Key Words
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Arrhythmias in athletes
top-level athletes, atrial fibrillation, prolonged palpitations, transoesophageal atrial
pacing/recoding, electrophysiologic testing, OA
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