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Atrial fibrillation and exercise

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https://www.readbyqxmd.com/read/29891251/exercise-and-atrial-fibrillation-prevention-or-causation
#1
Adrian D Elliott, Dominik Linz, Christian V Verdicchio, Prashanthan Sanders
Regular exercise contributes to improved cardiovascular health and reduced cardiovascular mortality. Previous studies have shown that regular physical activity and high cardiorespiratory fitness both contribute to a reduction in incident atrial fibrillation (AF). However, the risk of AF appears to be paradoxically increased by participation in endurance exercise. Although the mechanisms are not well understood, exercise-induced changes in autonomic tone alongside the development of an arrhythmogenic atrial substrate, appear to contribute to an excess of AF amongst athletes, despite an overall reduction in cardiovascular disease incidence...
May 8, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29861323/management-of-atrial-fibrillation-in-the-athlete
#2
Hariharan Raju, Jonathan M Kalman
Atrial fibrillation (AF) is a recognised arrhythmic risk of endurance sports participation, predominantly affecting middle-aged men who are lifelong athletes. Affected athletes were historically included in the category of lone AF, although specific pathophysiological processes apply to this condition, referred to as exercise-related AF. Younger non-endurance athletes may also present with AF, particularly when associated with co-existing cardiomyopathy or arrhythmia syndrome. Management of exercise-related AF is largely based on evidence from randomised trials in non-athletes...
May 8, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29842800/excessive-exercise-in-endurance-athletes-is-atrial-fibrillation-a-possible-consequence
#3
Jack M Goodman, Laura Banks, Kim A Connelly, Andrew Yan, Peter H Backx, Paul Dorian
Moderate physical activity levels are associated with increased longevity and lower risk of atrial fibrillation (AF). However, the relative risk of lone AF is 3-5 fold higher in intensive endurance-trained athletes compared to healthy adults. There is growing concern that 'excessive' endurance exercise may promote cardiac remodeling leading to long-term adverse consequences. The pathogenesis of exercise-induced AF is thought to arise from an interplay of multiple acute and chronic factors, including atrial enlargement, pro-fibrotic tendency, high vagal tone, and genotypic profile, which collectively promote adverse atrial remodeling...
May 29, 2018: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/29802801/long-term-effects-of-percutaneous-fenestration-following-the-fontan-procedure-in-adult-patients-with-congenital-univentricular-heart
#4
Monika Smaś-Suska, Beata Róg, Piotr Weryński, Wojciech Płazak, Monika Komar, Maria Olszowska, Piotr Podolec, Lidia Tomkiewicz-Pająk
BACKGROUND The Fontan procedure, performed for univentricular heart, may also include the technique of percutaneous fenestration to create a small atrial septal defect (ASD) and a right-to-left shunt. The aim of this study was to evaluate the long-term effects of fenestration in adult patients who had a Fontan procedure for univentricular heart. MATERIAL AND METHODS Fontan surgery was performed in 39 patients, including 19 (49%) patients with fenestration (Group I), and 20 (51%) patients without the fenestration procedure (Group II)...
May 26, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29794400/effect-of-atrial-fibrillation-on-the-incidence-and-outcome-of-osteoporotic-fracture-a-nationwide-population-based-study
#5
Daehoon Kim, Pil-Sung Yang, Tae-Hoon Kim, Jae-Sun Uhm, Junbeom Park, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung
BACKGROUND: Both atrial fibrillation (AF) and osteoporosis are common in older adults. The purpose of this study was to investigate whether comorbid AF in patients with osteoporosis is associated with fracture incidence, or death after fracture.Methods and Results:From the National Health Insurance Service database of Korea, we selected 31,778 patients with osteoporosis. During a median follow-up of 48 months, the incidence of bone fractures was higher in AF patients than in non-AF patients (3...
May 24, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29792299/a-simple-evidence-based-approach-to-help-guide-diagnosis-of-heart-failure-with-preserved-ejection-fraction
#6
Yogesh N V Reddy, Rickey E Carter, Masaru Obokata, Margaret M Redfield, Barry A Borlaug
Background -Diagnosis of heart failure with preserved ejection fraction (HFpEF) is challenging in euvolemic patients with dyspnea, and no evidence-based criteria are available. We sought to develop and then validate non-invasive diagnostic criteria that could be used to estimate the likelihood that HFpEF is present among patients with unexplained dyspnea in order to guide further testing. Methods -Consecutive patients with unexplained dyspnea referred for invasive hemodynamic exercise testing were retrospectively evaluated...
May 23, 2018: Circulation
https://www.readbyqxmd.com/read/29786450/atrial-fibrillation-symptom-clusters-and-associated-clinical-characteristics-and-outcomes-a-cross-sectional-secondary-data-analysis
#7
Megan Streur, Sarah J Ratcliffe, David Callans, M Benjamin Shoemaker, Barbara Riegel
BACKGROUND: Symptom clusters among adults with atrial fibrillation have previously been identified but no study has examined the relationship between symptom clusters and outcomes. AIMS: The purpose of this study was to identify atrial fibrillation-specific symptom clusters, characterize individuals with each cluster, and determine whether symptom cluster membership is associated with healthcare utilization. METHODS: This was a cross-sectional secondary data analysis of 1501 adults from the Vanderbilt Atrial Fibrillation Registry with verified atrial fibrillation...
May 1, 2018: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29759716/atrial-fibrillation-in-athletes-a-lesson-in-the-virtue-of-moderation
#8
REVIEW
N A Mark Estes, Christopher Madias
Although the cardiovascular benefits of moderate exercise are well established, there is growing epidemiological support for the notion that high-intensity endurance athletics increases the risk of atrial fibrillation (AF). There are many gaps in evidence related to epidemiology and mechanisms of AF in endurance athletes. The proposed pathophysiological mechanisms include alterations of autonomic tone, electrical remodeling, anatomical remodeling, fibrosis, and inflammation. Clinical management of the athlete with AF often includes a period of decreased frequency, intensity, and duration of exercise with assessment for improvement in AF recurrence...
September 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29749082/effect-of-induced-chronic-atrial-fibrillation-on-exercise-performance-in-standardbred-trotters
#9
Rikke Buhl, Helena Carstensen, Eva Zander Hesselkilde, Bjørg Zinkernagel Klein, Karen Margrethe Hougaard, Kirsten Bomberg Ravn, Ameli Victoria Loft-Andersen, Merle Friederike Fenner, Christian Pipper, Thomas Jespersen
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia affecting performance in horses. However, no previous studies have quantified the performance reduction in horses suffering from AF. OBJECTIVES: To quantify the effect of AF on maximum velocity (Vmax ), maximum heart rate (HRmax ), heart rate recovery (T100 ), hematologic parameters and development of abnormal QRS complexes. ANIMALS: Nine Standardbred trotters. METHODS: Two-arm controlled trial...
May 10, 2018: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29748195/does-high-intensity-endurance-training-increase-the-risk-of-atrial-fibrillation-a-longitudinal-study-of-left-atrial-structure-and-function
#10
Mildred A Opondo, Norman Aiad, Matthew A Cain, Satyam Sarma, Erin Howden, Douglas A Stoller, Jason Ng, Pieter van Rijckevorsel, Michinari Hieda, Takashi Tarumi, M Dean Palmer, Benjamin D Levine
BACKGROUND: Exercise mitigates many cardiovascular risk factors associated with atrial fibrillation. Endurance training has been associated with atrial structural changes which can increase the risk for atrial fibrillation. The dose of exercise training required for these changes is uncertain. We sought to evaluate the impact of exercise on left atrial (LA) mechanical and electrical function in healthy, sedentary, middle-aged adults. METHODS: Sixty-one adults (52±5 years) were randomized to either 10 months of high-intensity exercise training or yoga...
May 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29743909/improvement-of-physical-capacity-in-patients-undergoing-transcatheter-closure-of-atrial-septal-defects
#11
Paweł Prochownik, Tadeusz Przewłocki, Piotr Podolec, Piotr Wilkołek, Bartosz Sobień, Urszula Gancarczyk, Natalia Podolec, Monika Komar
Introduction: Atrial septal defect (ASD) is the most common congenital cardiac anomaly diagnosed in adults. It often remains asymptomatic until the fourth or fifth decade of life. Significant left-to-right interatrial shunting is associated with the risk of heart failure, pulmonary hypertension and atrial fibrillation. Percutaneous ASD closure is a recognized method of treatment. Aim: To evaluate the clinical outcomes and physical capacity in patients undergoing transcatheter closure of ostium secundum ASD...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/29714993/issues-in-geriatric-care-falls
#12
Dipesh Patel, Richard J Ackermann
One in three older adults falls each year. There are approximately 2.5 million falls among older adults treated in emergency departments. Falls account for 87% of all fractures in this age group. The biggest risk factor for falling is a history of falls. Other risk factors include frailty, sedative and anticholinergic drugs, polypharmacy, and a variety of medical conditions. Current recommendations are that all patients age 65 years and older should be asked about falls each year. Patients also can be screened for fall risk with a variety of approaches including questionnaires and the Timed Up & Go test...
May 2018: FP Essentials
https://www.readbyqxmd.com/read/29709893/treatment-strategies-for-atrial-fibrillation-with-left-ventricular-systolic-dysfunction-meta-analysis
#13
Jinhee Ahn, Hyun Jung Kim, Jeong Cheon Choe, Jin Sup Park, Hye Won Lee, Jun-Hyok Oh, Jung Hyun Choi, Han Cheol Lee, Kwang Soo Cha, Taek Jong Hong, Young-Hoon Kim
BACKGROUND: Atrial fibrillation (AF) frequently coexists with heart failure (HF) with reduced ejection fraction (EF). This meta-analysis compared AF control strategies, that is, rhythm vs. rate, and catheter ablation (CA) vs. anti-arrhythmic drugs (AAD) in patients with AF combined with HF.Methods and Results:The MEDLINE, EMBASE, and CENTRAL databases were searched, and 13 articles from 11 randomized controlled trials with 5,256 patients were included in this meta-analysis. The outcomes were echocardiographic parameters (left ventricular EF, LVEF), left atrial (LA) size, and left ventricular end-systolic volume, LVESV), clinical outcomes (mortality, hospitalization, and thromboembolism), exercise capacity, and quality of life (QOL)...
April 27, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29706494/is-there-a-role-for-genes-in-exercise-induced-atrial-cardiomyopathy
#14
REVIEW
Diane Fatkin, Charles D Cox, Inken G Huttner, Boris Martinac
In endurance athletes, prolonged high intensity exercise participation can have deleterious effects on the myocardium with subsequent structural and electrical remodelling. In a subset of athletes, there is a predilection for atrial involvement and the risk of atrial fibrillation (AF) is increased. The mechanisms underpinning exercise-induced atrial cardiomyopathy have yet to be fully elucidated and the contribution of an individual's genetic makeup is unknown. Some athletes may have rare genetic variants that are sufficient to cause AF irrespective of exercise exposure...
April 9, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29663455/frequent-atrial-premature-complexes-during-exercise-a-potent-predictor-of-atrial-fibrillation
#15
Jin Kyung Hwang, Hye Bin Gwag, Seung-Jung Park, Young Keun On, June Soo Kim, Kyoung-Min Park
BACKGROUND: The clinical significance of atrial premature complexes (APCs) during exercise is unclear. HYPOTHESIS: Frequent APCs during exercise provides prognostic information. METHODS: A total of 998 patients were divided into 2 groups based on the presence of frequent APCs during treadmill testing (>5 beats per stage): the FAPC group (n = 128) vs the non-FAPC group (n = 870). The primary outcome was new-onset atrial fibrillation or flutter (AF/AFL) during follow-up period (356...
April 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29652731/obesity-and-cardiovascular-risk-a-call-for-action-from-the-european-society-of-hypertension-working-group-of-obesity-diabetes-and-the-high-risk-patient-and-european-association-for-the-study-of-obesity-part-b-obesity-induced-cardiovascular-disease-early-prevention
#16
Vasilios Kotsis, Konstantinos Tsioufis, Christina Antza, Gino Seravalle, Antonio Coca, Cristina Sierra, Empar Lurbe, Stella Stabouli, Bojan Jelakovic, Josep Redon, Pau Redon, Peter M Nilsson, Jens Jordan, Dragan Micic, Nicholas Finer, Deborah R Leitner, Hermann Toplak, Lale Tokgozoglu, Vasilios Athyros, Moses Elisaf, Theodosios D Filippatos, Guido Grassi
: Obesity predisposes for atrial fibrillation, heart failure, sudden cardiac death, renal disease and ischemic stroke, which are the main causes of cardiovascular hospitalization and mortality. As obesity and the cardiovascular effects on the vessels and the heart start early in life, even from childhood, it is important for health policies to prevent obesity very early before the disease manifestation emerge. Key roles in the prevention are strategies to increase physical exercise, reduce body weight and to prevent or treat hypertension, lipids disorders and diabetes earlier and efficiently to prevent cardiovascular complications...
July 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29650239/lifestyle-therapy-for-the-management-of-atrial-fibrillation
#17
REVIEW
Ahmad A Abdul-Aziz, Mahmoud Altawil, Amanda Lyon, Mark MacEachern, Caroline R Richardson, Melvyn Rubenfire, Frank Pelosi, Elizabeth A Jackson
Atrial fibrillation (AF) is a common arrhythmia associated with increased risk of morbidity and mortality. There is evidence that lifestyle interventions may serve as complementary treatments to reduce AF burden. The objective of this review was to summarize the efficacy of lifestyle interventions for the management of AF. Studies which included patients with systolic heart failure (ejection fraction ≤40%), and those limited to an examination of vigorous physical activity were excluded from our search. Studies were identified through a search of the following databases: MEDLINE, EMBASE, CINAHIL, and PubMed, run from inception through August 2016...
May 1, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29593565/aerobic-interval-training-prevents-age-dependent-vulnerability-to-atrial-fibrillation-in-rodents
#18
Vegard Malmo, Allen Kelly, Karin S Garten, Tomas Stolen, Natale P L Rolim, Ulrik Wisloff, Godfrey Smith, Jan P Loennechen
Aims: Increasing age is the most important risk factor for atrial fibrillation (AF). Very high doses of exercise training might increase AF risk, while moderate levels seem to be protective. This study aimed to examine the effects of age on vulnerability to AF and whether long-term aerobic interval training (AIT) could modify these effects. Methods: Nine months old, male Sprague-Dawley rats were randomized to AIT for 16 weeks (old-ex) or to a sedentary control group (old-sed), and compared to young sedentary males (young-sed)...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29573575/heart-rate-response-and-functional-capacity-in-patients-with-chronic-heart-failure-with-preserved-ejection-fraction
#19
Eloy Domínguez, Patricia Palau, Eduardo Núñez, José María Ramón, Laura López, Joana Melero, Alejandro Bellver, Enrique Santas, Francisco J Chorro, Julio Núñez
AIMS: The mechanisms of exercise intolerance in heart failure with preserved ejection fraction (HFpEF) are not yet elucidated. Chronotropic incompetence has emerged as a potential mechanism. We aimed to evaluate whether heart rate (HR) response to exercise is associated to functional capacity in patients with symptomatic HFpEF. METHODS AND RESULTS: We prospectively studied 74 HFpEF patients [35.1% New York Heart Association Class III, 53% female, age (mean ± standard deviation) 72...
March 24, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29551898/patient-perspectives-of-participating-in-the-cardiac-copenheartrfa-rehabilitation-program-for-patients-treated-with-ablation-for-atrial-fibrillation
#20
Signe S Risom, Johanne Lind, Pamela J McCabe, Selina Kikkenborg Berg
Purpose: The CopenHeartRFA trial was designed and conducted to explore the effects of rehabilitation on patients treated with ablation for atrial fibrillation (AF). It included a cardiac rehabilitation program consisting of physical exercise and psychoeducational consultations over 6 months. As part of the evaluation of the CopenHeartRFA trial, both quantitative and qualitative data were collected. The intervention was delivered by a multidisciplinary team. Aim: This study aimed to understand the experience of patients treated for AF with ablation who participated in the CopenHeartRFA cardiac rehabilitation program...
2018: Journal of Multidisciplinary Healthcare
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