State of the Art Review: Atrial Fibrillation in Athletes

M. Darragh Flannery, Jonathan M. Kalman, Prashanthan Sanders, André La Gerche

Research output: Contribution to journalReview article

19 Citations (Scopus)


Exercise has substantial health benefits with pleomorphic vascular, metabolic, psychological and anti-neoplastic actions resulting in improved quality of life and longevity. Despite these many benefits, numerous studies have shown that endurance athletes are more likely to develop atrial fibrillation (AF) than non-athletes. The type, intensity and amount of sport appears to influence the risk of developing AF. Several endurance sport activities have been shown to increase the risk of developing AF but an excess in AF has not been shown in non-endurance sports. Furthermore, lifetime hours of participation appear to increase the risk of developing AF. Intriguingly, women appear relatively protected and an association between endurance sport and AF has not been clearly demonstrated amongst female endurance athletes. The mechanisms by which endurance sport promotes the development of AF are unclear. There are, however, a number of pathophysiological mechanisms which are known to increase the risk of AF in non-athletes which have correlates in athletes. These include structural remodelling of the left atrium, elevated left atrial pressure, inflammation, myocardial fibrosis, vagal tone, sinus bradycardia and genetic predisposition. In this article, we explore how some of these mechanisms may contribute to the development of AF in endurance athletes.

Number of pages7
JournalHeart Lung and Circulation
Issue number9
Publication statusPublished - 1 Sep 2017


  • Athlete
  • Atrial fibrillation
  • Endurance sport

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Flannery, M. D., Kalman, J. M., Sanders, P., & La Gerche, A. (2017). State of the Art Review: Atrial Fibrillation in Athletes. Heart Lung and Circulation, 26(9), 983-989.