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Atrial fibrillation and exercise

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https://www.readbyqxmd.com/read/28090681/excess-of-exercise-increases-the-risk-of-atrial-fibrillation
#1
REVIEW
A Müssigbrodt, A Weber, J Mandrola, Y van Belle, S Richter, M Döring, A Arya, P Sommer, A Bollmann, G Hindricks
An interesting and still not well-understood example for old medical wisdom "Sola dosis facit venenum" is the increased prevalence of atrial fibrillation (AF) in athletes. Numerous studies have shown a fourfold to eightfold increased risk of AF in athletes compared to the normal population. Analysis of the existing data suggests a dose-dependent effect of exercise. Moderate exercise seems to have a protective effect and decreases the risk of AF, whereas excessive exercise seems to increase the risk of AF. The described cases illustrate clinical manifestations within the spectrum of AF in elderly athletes, that is, exercise-induced AF, vagal AF, chronic AF, and atrial flutter...
January 16, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/28076389/a-computational-study-on-the-relation-between-resting-heart-rate-and-atrial-fibrillation-hemodynamics-under-exercise
#2
Matteo Anselmino, Stefania Scarsoglio, Andrea Saglietto, Fiorenzo Gaita, Luca Ridolfi
AIMS: Clinical data indicating a heart rate (HR) target during rate control therapy for permanent atrial fibrillation (AF) and assessing its eventual relationship with reduced exercise tolerance are lacking. The present study aims at investigating the impact of resting HR on the hemodynamic response to exercise in permanent AF patients by means of a computational cardiovascular model. METHODS: The AF lumped-parameter model was run to simulate resting (1 Metabolic Equivalent of Task-MET) and various exercise conditions (4 METs: brisk walking; 6 METs: skiing; 8 METs: running), considering different resting HR (70 bpm for the slower resting HR-SHR-simulations, and 100 bpm for the higher resting HR-HHR-simulations)...
2017: PloS One
https://www.readbyqxmd.com/read/28039126/are-olympic-athletes-free-from-cardiovascular-diseases-systematic-investigation-in-2352-participants-from-athens-2004-to-sochi-2014
#3
Antonio Pelliccia, Paolo Emilio Adami, Filippo Quattrini, Maria Rosaria Squeo, Stefano Caselli, Luisa Verdile, Viviana Maestrini, Fernando Di Paolo, Cataldo Pisicchio, Roberto Ciardo, Antonio Spataro
CONTEXT: Olympic athletes represent model of success in our society, by enduring strenuous conditioning programmes and achieving astonishing performances. They also raise scientific and clinical interest, with regard to medical care and prevalence of cardiovascular (CV) abnormalities. OBJECTIVE: Our aim was to assess the prevalence and type of CV abnormalities in this selected athlete's cohort. DESIGN, SETTING AND PARTICIPANTS: 2352 Olympic athletes, mean age 25±6, 64% men, competing in 31 summer or 15 winter sports, were examined with history, physical examination, 12-lead and exercise ECG and echocardiography...
December 30, 2016: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28017355/atrial-fibrillation-in-heart-failure-with-preserved-ejection-fraction-association-with-exercise-capacity-left-ventricular-filling-pressures-natriuretic-peptides-and-left-atrial-volume
#4
Carolyn S P Lam, Michiel Rienstra, Wan Ting Tay, Licette C Y Liu, Yoran M Hummel, Peter van der Meer, Rudolf A de Boer, Isabelle C Van Gelder, Dirk J van Veldhuisen, Adriaan A Voors, Elke S Hoendermis
OBJECTIVES: This study sought to study the association of atrial fibrillation (AF) with exercise capacity, left ventricular filling pressure, natriuretic peptides, and left atrial size in heart failure with preserved ejection fraction (HFpEF). BACKGROUND: The diagnosis of heart failure with preserved ejection fraction (HFpEF) in patients with AF remains a challenge because both contribute to impaired exercise capacity, and increased natriuretic peptides and left atrial volume...
November 30, 2016: JACC. Heart Failure
https://www.readbyqxmd.com/read/27956001/relation-of-functional-status-to-risk-of-development-of-atrial-fibrillation
#5
Satish Ramkumar, Hong Yang, Ying Wang, Mark Nolan, Kazuaki Negishi, Prashanthan Sanders, Thomas Hugh Marwick
Identifying patients at risk is now important as there are demonstrable ways to alter disease progression which could potentially prevent atrial fibrillation (AF) and its complications. We sought whether impaired functional capacity was associated with risk of AF, independent of myocardial dysfunction. In this community-based study, asymptomatic participants aged ≥65 years were recruited if they had ≥1 risk factor (e.g., hypertension, diabetes mellitus, and obesity). Participants underwent baseline echocardiography (including measurement of myocardial mechanics) and six-minute walk test...
November 16, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27931611/arrhythmogenic-right-ventricular-cardiomyopathy-clinical-course-and-predictors-of-arrhythmic-risk
#6
Andrea Mazzanti, Kevin Ng, Alessandro Faragli, Riccardo Maragna, Elena Chiodaroli, Nicoletta Orphanou, Nicola Monteforte, Mirella Memmi, Patrick Gambelli, Valeria Novelli, Raffaella Bloise, Oronzo Catalano, Guido Moro, Valentina Tibollo, Massimo Morini, Riccardo Bellazzi, Carlo Napolitano, Vincenzo Bagnardi, Silvia G Priori
BACKGROUND: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a leading cause of sudden cardiac death, but its progression over time and predictors of arrhythmias are still being defined. OBJECTIVES: This study sought to describe the clinical course of ARVC and occurrence of life-threatening arrhythmic events (LAE) and cardiovascular mortality; identify risk factors associated with increased LAE risk; and define the response to therapy. METHODS: We determined the clinical course of 301 consecutive patients with ARVC using the Kaplan-Meier method adjusted to avoid the bias of delayed entry...
December 13, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27875477/smartphone-based-arrhythmia-monitoring
#7
Paul Garabelli, Stavros Stavrakis, Sunny Po
The use of smartphones for arrhythmia monitoring is another leap for ECG utilization and arrhythmia detection - effectively taking the technology to any smartphone user. Smart wearable technology, while very common, is limited mostly to activity tracking and exercise motivation. Rhythm strip generating smartphone products (Kardia Mobile by AliveCor and ECG Check by Cardiac Designs) are more powerful at arrhythmia detection than wearable monitors. These products, which have been studied in a variety of situations, rely on an external device with metal sensors to create a rhythm strip, which is usually Lead I...
January 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27855640/long-term-secondary-prevention-of-acute-myocardial-infarction-sepat-guidelines-adherence-and-outcome
#8
Constantinos Ergatoudes, Erik Thunström, Annika Rosengren, Lena Björck, Kristina Bengtsson Boström, Kristin Falk, Michael Fu
BACKGROUND: A number of registry studies have reported suboptimal adherence to guidelines for cardiovascular prevention during the first year after acute myocardial infarction (AMI). However, only a few studies have addressed long-term secondary prevention after AMI. This study evaluates prevention guideline adherence and outcome of guideline-directed secondary prevention in patients surviving 2 years after AMI. METHODS: Patients aged 18-85 years at the time of their index AMI were consecutively identified from hospital discharge records between July 2010 and December 2011 in Gothenburg, Sweden...
November 17, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27847152/endurance-exercise-induced-changes-in-bnp-concentrations-in-cardiovascular-patients-versus-healthy-controls
#9
Vincent L Aengevaeren, Maria T E Hopman, Dick H J Thijssen, Roland R van Kimmenade, Menko-Jan de Boer, Thijs M H Eijsvogels
BACKGROUND: Healthy athletes demonstrated increased B-type natriuretic peptide (BNP) concentrations following exercise, but it is unknown whether these responses are exaggerated in individuals with cardiovascular risk factors (CVRF) or disease (CVD). We compared exercise-induced increases in BNP between healthy controls (CON) and individuals with CVRF or CVD. Furthermore, we aimed to identify predictors for BNP responses. METHODS: Serum BNP concentrations were measured in 191 participants (60±12yrs) of the Nijmegen Marches before (baseline) and immediately after 4 consecutive days of walking exercise (30-50km/day)...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27830772/diagnosis-pathophysiology-and-management-of-exercise-induced-arrhythmias
#10
REVIEW
Eduard Guasch, Lluís Mont
The cardiovascular benefits of physical activity are indisputable. Nevertheless, growing evidence suggests that both atrial fibrillation and right ventricular arrhythmia can be caused by intense exercise in some individuals. Exercise-induced atrial fibrillation is most commonly diagnosed in middle-aged, otherwise healthy men who have been engaged in endurance training for >10 years, and is mediated by atrial dilatation, parasympathetic enhancement, and possibly atrial fibrosis. Cardiac ablation is evolving as a first-line tool for athletes with exercise-induced arrhythmia who are eager to remain active...
November 10, 2016: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/27823683/cardiac-rehabilitation-versus-usual-care-for-patients-treated-with-catheter-ablation-for-atrial-fibrillation-results-of-the-randomized-copenheartrfa-trial
#11
Signe S Risom, Ann-Dorthe Zwisler, Trine B Rasmussen, Kirstine Lærum Sibilitz, Trine L S Madsen, Jesper Hastrup Svendsen, Christian Gluud, Jane Lindschou, Per Winkel, Selina Kikkenborg Berg
BACKGROUND: To assess the effects of comprehensive cardiac rehabilitation compared with usual care on physical activity and mental health for patients treated with catheter ablation for atrial fibrillation. METHODS: The patients were randomized 1:1 stratified by paroxysmal or persistent atrial fibrillation and sex to cardiac rehabilitation consisting of 12 weeks physical exercise and four psycho-educational consultations plus usual care (cardiac rehabilitation group) versus usual care...
November 2016: American Heart Journal
https://www.readbyqxmd.com/read/27793993/severe-pulmonary-vein-stenosis-resulting-from-ablation-for-atrial-fibrillation-presentation-management-and-clinical-outcomes
#12
Erin A Fender, R Jay Widmer, David O Hodge, George M Cooper, Kristi H Monahan, Laurie A Peterson, David R Holmes, Douglas L Packer
BACKGROUND: The frequency of pulmonary vein stenosis (PVS) after ablation for atrial fibrillation has decreased, but it remains a highly morbid condition. Although treatment strategies including pulmonary vein dilation and stenting have been described, the long-term impacts of these interventions are unknown. We evaluated the presentation of severe PVS, and examined the risk for restenosis after intervention using either balloon angioplasty (BA) alone or BA with stenting. METHODS: This was a prospective, observational study of 124 patients with severe PVS evaluated between 2000 and 2014...
December 6, 2016: Circulation
https://www.readbyqxmd.com/read/27779336/improvement-in-the-prediction-of-exercise-induced-elevation-of-left-ventricular-filling-pressure-in-patients-with-normal-left-ventricular-ejection-fraction
#13
Jaroslav Meluzin, Zdenek Starek, Tomas Kulik, Jiri Jez, Frantisek Lehar, Josef Tomandl, Ladislav Dusek, Jiri Wolf, Pavel Leinveber, Miroslav Novak
BACKGROUND: Noninvasive diagnosis of exercise-induced elevation of left ventricular filling pressure is difficult and remains unsatisfactory. The aim of this study was to assess the accuracy of the ratio of early diastolic transmitral (E) to mitral annular (e') velocity and to determine new parameters or parameter combinations with the ability to predict exercise-induced left atrial pressure (LAP) elevation. METHODS AND RESULTS: Eighty patients with paroxysmal atrial fibrillation (AF) referred for catheter AF ablation underwent simultaneous exercise echocardiography and direct invasive LAP measurements, as well as a resting and postexercise biomarker analysis...
October 25, 2016: Echocardiography
https://www.readbyqxmd.com/read/27776250/atrial-fibrillation-in-highly-trained-endurance-athletes-description-of-a-syndrome
#14
REVIEW
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')...
January 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27753048/long-term-competitive-swimming-and-the-association-with-atrial-fibrillation
#15
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
https://www.readbyqxmd.com/read/27747784/cardiovascular-risk-and-disease-among-masters-endurance-athletes-insights-from-the-boston-master-masters-athletes-survey-to-evaluate-risk-initiative
#16
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
https://www.readbyqxmd.com/read/27746058/plasma-serotonin-in-heart-failure-possible-marker-and-potential-treatment-target
#17
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
https://www.readbyqxmd.com/read/27738481/prognostic-importance-of-exercise-brain-natriuretic-peptide-in-asymptomatic-chronic-organic-severe-mitral-regurgitation-an-observational-study
#18
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
https://www.readbyqxmd.com/read/27714654/physical-activity-endurance-exercise-and-excess-can-one-overdose
#19
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
https://www.readbyqxmd.com/read/27707827/improved-exercise-tolerance-in-patients-with-preserved-ejection-fraction-by-spironolactone-on-myocardial-fibrosis-in-atrial-fibrillation-rationale-and-design-of-the-impress-af-randomised-controlled-trial
#20
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
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