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Atrial fibrillation and exercise

Fabian Sanchis-Gomar, Carme Perez-Quilis, Giuseppe Lippi, Gianfranco Cervellin, Roman Leischik, Herbert Löllgen, Enrique Serrano-Ostáriz, Alejandro Lucia
Atrial fibrillation (AF) is the most common heart arrhythmia, the risk of which typically increases with age. This condition is commonly associated with major cardiovascular diseases and structural heart damage, while it is rarely observed in healthy young people. However, increasing evidence indicates that paroxysmal AF can also onset in young or middle-aged and otherwise healthy endurance athletes (e.g., cyclists, runners and cross-country skiers). Here we review the topic of AF associated with strenuous endurance exercise (SEE), for example cycling, running and cross-country skiing, especially at a competitive level, and we propose the definition of a new syndrome based on the accumulating data in the literature: SEE-related AF under the acronym of 'PAFIYAMA' ('paroxysmal AF in young and middle-aged athletes')...
October 19, 2016: International Journal of Cardiology
Andrew D Schreiner, Brad A Keith, Karen E Abernathy, Jingwen Zhang, Walter A Brzezinski
BACKGROUND: Endurance exercise plays a role in cardiovascular risk reduction, but may also be a risk factor for atrial fibrillation. This study was performed to assess the prevalence of atrial fibrillation in a population of long-term, competitive swimmers compared with patients within an internal medicine clinic with known risk factors for atrial fibrillation such as diabetes mellitus and hypertension. METHODS: This cross-sectional study utilized survey data comparing the prevalence of atrial fibrillation in swimmers to a general internal medicine population...
December 2016: Sports Medicine—Open
Kayle Shapero, James Deluca, Miranda Contursi, Meagan Wasfy, Rory B Weiner, Gregory D Lewis, Adolph Hutter, Aaron L Baggish
BACKGROUND: Masters athletes (MAs), people over the age of 35 that participate in competitive sports, are a rapidly growing population that may be uniquely at risk for cardiovascular (CV) disease. The objective of this study was to develop a comprehensive clinical CV profile of MA. METHODS: An electronic Internet-based survey (survey response rate = 66 %) was used to characterize a community cohort of MAs residing in Eastern Massachusetts, USA. Clinical and lifestyle factors associated with prevalent CV disease were determined using logistic regression...
December 2016: Sports Medicine—Open
Ahmed M Selim, Nitasha Sarswat, Iosif Kelesidis, Muhammad Iqbal, Ramesh Chandra, Ronald Zolty
BACKGROUND: The relationship between heart failure (HF) and the serotonergic system has been established in animal studies. However, data on human plasma serotonin level in HF and its significance over the course of the disease is lacking. METHODS: Serotonin levels were measured in 173 patients (108 males, 65 females), 116 were stable HF and 40 were acute decompensated HF patients. The normal control group included 17 healthy volunteers with no known medical or psychiatric conditions...
September 17, 2016: Heart, Lung & Circulation
Santosh Kumar Sinha, Shalini Garg, Ramesh Thakur, Vinay Krishna, Karandeep Singh, Mohit Sachan, Amit Goel, Mahamdula Razi, Umeshwar Pandey, Chandra Mohan Varma
BACKGROUND: The optimal timing of surgery in patients with chronic organic severe mitral regurgitation (MR) continues to be debated, especially for those who are asymptomatic. The aim of the study was to determine independent and additive prognostic value of exercise brain natriuretic peptide (eBNP) in patients with severe asymptomatic MR and normal left ventricular ejection fraction (LVEF). METHODS: Two hundred twenty-three consecutive patients with severe MR defined by effective regurgitant orifice (ERO) area ≥ 40 mm(2) and/or residual volume ≥ 60 mL, LVEF > 60%, and normal LV end-systolic diameter < 40 mm underwent symptom limited exercise treadmill test (TMT)...
November 2016: Journal of Clinical Medicine Research
Jonathan H Kim, Aaron L Baggish
Although moderate levels of exercise reduce cardiovascular morbidity and mortality in the general population, recent data have questioned whether higher doses of physical activity are associated with diminished health benefits and adverse outcomes. This review focuses on several issues at the center of this controversy including epidemiologic data describing mortality trends in those who engage in high levels of physical activity and recent observational data suggesting adverse cardiovascular outcomes among long-term endurance athletes...
November 2016: Current Treatment Options in Cardiovascular Medicine
Eduard Shantsila, Ronnie Haynes, Melanie Calvert, James Fisher, Paulus Kirchhof, Paramjit S Gill, Gregory Y H Lip
INTRODUCTION: Patients with atrial fibrillation frequently suffer from heart failure with preserved ejection fraction. At present there is no proven therapy to improve physical capacity and quality of life in participants with permanent atrial fibrillation with preserved left ventricular contractility. OBJECTIVE: The single-centre IMproved exercise tolerance In heart failure With PReserved Ejection fraction by Spironolactone On myocardial fibrosiS In Atrial Fibrillation (IMPRESS-AF) trial aims to establish whether treatment with spironolactone as compared with placebo improves exercise tolerance (cardiopulmonary exercise testing), quality of life and diastolic function in patients with permanent atrial fibrillation...
October 5, 2016: BMJ Open
Martin Fiala, Veronika Bulková, Libor Škňouřil, Renáta Nevřalová, Ondřej Toman, Jaroslav Januška, Jindřich Špinar, Dan Wichterle
AIMS: Identifying patients who benefit from restored sinus rhythm (SR) would optimize the selection of candidates for ablation of long-standing persistent atrial fibrillation (LSPAF). This prospective study sought to identify the hitherto unknown factors associated with global functional improvement after successful radiofrequency catheter ablation of LSPAF. METHODS AND RESULTS: In 171 LSPAF patients (84% of the total consecutive 203 patients) who were examined in SR 12 months after ablation, the individual per cent change from baseline value in maximum oxygen consumption at exercise test (VO2 max), left ventricular ejection fraction (LVEF), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and five-dimensional descriptive system (EQ-5D) of quality-of-life questionnaire were classified in quartiles by 0 (worse) to 3 (best) grades...
October 5, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Adrian D Elliott, Rajiv Mahajan, Dennis H Lau, Prashanthan Sanders
Exercise training has considerable health benefits. However, recent research has demonstrated a greater risk of atrial arrhythmias in endurance athletes. The mechanisms promoting atrial fibrillation in athletes are unclear but there seems to be a central role for atrial remodeling, accompanied by autonomic alterations and inflammation. Animal studies have provided unique insights, yet prospective human data are lacking. Treatment options seem to yield similar efficacy to that seen in a nonathletic population and may be justified as an early rhythm control strategy...
November 2016: Cardiology Clinics
Rupert K Hung, Mouaz H Al-Mallah, Seamus P Whelton, Erin D Michos, Roger S Blumenthal, Jonathan K Ehrman, Clinton A Brawner, Steven J Keteyian, Michael J Blaha
Whether lower heart rate thresholds (defined as the percentage of age-predicted maximal heart rate achieved, or ppMHR) should be used to determine chronotropic incompetence in patients on beta-blocker therapy (BBT) remains unclear. In this retrospective cohort study, we analyzed 64,549 adults without congestive heart failure or atrial fibrillation (54 ± 13 years old, 46% women, 29% black) who underwent clinician-referred exercise stress testing at a single health care system in Detroit, Michigan from 1991 to 2009, with median follow-up of 10...
August 31, 2016: American Journal of Cardiology
Inger Njølstad, Ellisiv B Mathiesen, Henrik Schirmer, Dag Steinar Thelle
The rapid increase of coronary heart disease mortality in Northern Norway during 1951-1970 was why the newly established University of Tromsø decided to start a study to identify major operating cardiovascular risk factors. The first Tromsø survey in 1974 suggested that the relatively high cardiovascular mortality was associated with elevated cholesterol levels and high prevalence of smoking, while high-density-lipoprotein-cholesterol (HDL-C) was identified as a preventive factor. After 1974, six more surveys including both genders (aged 20 to 89 years) were undertaken...
September 21, 2016: Scandinavian Cardiovascular Journal: SCJ
Lars H Tang, Ann-Dorthe Zwisler, Selina K Berg, Patrick Doherty, Rod S Taylor, Henning Langberg
OBJECTIVES: The aim of this study was to investigate if exercise intensity guided by rating of perceived exertion (RPE) results in an equivalent cardiovascular response when applied in either a center-based or a home-based setting. DESIGN: Data from patients with heart disease (post-valve surgery and atrial fibrillation post-radiofrequency ablation) participating in exercise-based rehabilitation were included. Patients performed a 12-week program in either a center- or a home-based setting...
September 14, 2016: American Journal of Physical Medicine & Rehabilitation
Giuseppe Caminiti, Chiara Fossati, Giuseppe Rosano, Maurizio Volterrani
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
Shao-Min Chen, Rong He, Wei-Hong Li, Zhao-Ping Li, Bao-Xia Chen, Xin-Heng Feng
BACKGROUND: Elevated left ventricular filling pressure (LVFP) is an important cause of exercise intolerance in patients with atrial fibrillation (AF). Exercise stress echocardiography could assess LVFP during exercise. The objective of this study was to investigate the relationship between exercise induced elevation of LVFP and exercise capacity in patients with AF. METHODS: This study included 145 consecutive patients (81 men and 64 women; mean age 65.5 ± 8.0 years) with persistent non-valvular AF and normal left ventricular systolic function (left ventricular ejection fraction ≥ 50%)...
September 2016: Journal of Geriatric Cardiology: JGC
Yuko Kato, Shinya Suzuki, Tokuhisa Uejima, Hiroaki Semba, Hiroto Kano, Shunsuke Matsuno, Hideaki Takai, Takayuki Otsuka, Yuji Oikawa, Kazuyuki Nagashima, Hajime Kirigaya, Koichi Sagara, Takashi Kunihara, Junji Yajima, Hitoshi Sawada, Tadanori Aizawa, Takeshi Yamashita
This study aimed to examine the discrete impacts of peak oxygen consumption (VO2) and brain natriuretic peptide (BNP) levels on future heart failure (HF) events in sinus rhythm (SR) and atrial fibrillation (AF). A total of 1447 patients who underwent symptom-limited cardiopulmonary exercise testing and whose BNP values were determined simultaneously were analysed (SR, N = 1151 and AF, N = 296). HF events were defined as HF hospitalization or HF death. Over a mean follow-up period of 1472 days, 140 HF events were observed...
August 22, 2016: Heart and Vessels
Min Zhu, Xinbin Zhou, Hongwen Cai, Zhijun Wang, Huimin Xu, Shenjie Chen, Jie Chen, Xiaoming Xu, Haibin Xu, Wei Mao
BACKGROUND: The effectiveness of restoring the sinus rhythm by catheter ablation relative to that of medical rate control for persistent atrial fibrillation (AF) patients with heart failure (HF) remains to be defined. METHODS: We systematically searched Embase, Pubmed, the Cochrane Library, and for articles that compared the outcomes of interest between catheter ablation and medical rate control therapy in persistent AF patients with HF and left ventricular systolic dysfunction (LVSD)...
July 2016: Medicine (Baltimore)
Mark S Link, Michel Haïssaguerre, Andrea Natale
Atrial fibrillation (AF) is the most common arrhythmia encountered by cardiologists and is a major cause of morbidity and mortality. Risk factors for AF include age, male sex, genetic predisposition, hypertension, diabetes mellitus, sleep apnea, obesity, excessive alcohol, smoking, hyperthyroidism, pulmonary disease, air pollution, heart failure, and possibly excessive exercise. The management of AF involves decisions about rate versus rhythm control. Asymptomatic patients are generally managed with rate control and anticoagulation...
July 26, 2016: Circulation
Thijs M H Eijsvogels, Keith P George, Paul D Thompson
PURPOSE OF REVIEW: Habitual physical activity can reduce the risk of future cardiovascular morbidity and mortality. This review evaluates recent publications that have assessed the impact of the dose of physical (in)activity on cardiovascular outcomes. RECENT FINDINGS: Sedentary behavior, characterized by prolonged sitting, is increasingly prevalent across the globe and increases the risk for cardiovascular events in a dose-dependent fashion. Similarly, the number of individuals performing endurance exercise events has tripled over the last 2 decades, and some studies suggest that the high volumes of exercise training and competition may attenuate the health benefits of a physically active lifestyle...
September 2016: Current Opinion in Cardiology
Natale Daniele Brunetti, Francesco Santoro, Michele Correale, Luisa De Gennaro, Giusy Conte, Matteo Di Biase
The link between physical activity and the risk of atrial fibrillation (AF) remains controversial. We therefore sought to further assess by a meta-analysis whether increased levels of physical activity may increase the risk of AF. In October 2015, a PubMed research was conducted for studies that investigated this topic. We identified 11 relevant studies with a total of 81,787 participants. The pooled analysis did not show an increased risk of AF in subjects practicing physical activity (odds ratio (OR)=0.92, 95% C...
October 15, 2016: International Journal of Cardiology
Marios Kolios, Panagiotis Korantzopoulos, Antonios P Vlahos, Eleni Kapsali, Evangelos Briasoulis, John A Goudevenos
BACKGROUND: There seems to be a significant arrhythmia burden in β-thalassemia major (TM) patients without overt cardiomyopathy. Apart from conventional electrocardiographic (ECG) and arrhythmic risk markers we studied novel markers of ventricular repolarization and autonomic imbalance both at rest and after exercise testing. METHODS: We studied 47 adult TM patients without systolic heart failure and 47 age and sex-matched healthy control subjects. The median age of the studied population was 36 [32-43] years, 57% men...
October 15, 2016: International Journal of Cardiology
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