Is there a temporal relationship between training sessions and the onset of atrial fibrillation episodes in endurance-trained individuals?

Abstract

Mål: Det er lite undersøkt hva som trigger anfall av atrieflimmer (AF) hos godt trente personer diagnostisert med anfallsvis AF. Målet med denne studien er å undersøke om det er en tidsmessig sammenheng mellom treningsøkter og AF episoder i denne gruppen av AF-pasienter. Metode: Blant 30 studiedeltakere i studien Effects of Detraining in Endurance Athletes with Paroxysmal Atrial Fibrillation study (NEXAF) ble AF episoder registrert med en implanterbar hjerterytmemonitor (ICM) i 5-16 uker. Deltakerne ble instruert til å trene som vanlig og å logge øktene med en treningsklokke koblet til et pulsbelte. Det ble undersøkt hvorvidt AF episoder vanligvis ble utløst under eller rett etter treningsøkter. Resultat: Av 1458 registrerte AF episoder startet 95 (6.7%) under trening, 57 (3.9%) <3 timer etter trening og 1306 (89.7%) >3 timer etter trening. Dette tilsvarer en hendelsesrate på 2.07, 0.46 og 0.95 per 24 timer med overvåking. Sammenlignet med >3 timer etter trening var rate ratio for tilbakevendende AF episoder 2.18 for AF under trening og 0.48 for AF <3 timer etter trening. Konklusjon: Risikoen for AF episoder så ut til å være høyest under treningsøkter blant godt trente personer diagnostisert med AF. Det var store individuelle forskjeller, noe som understreker viktigheten av individuell tilpasning i behandling og oppfølging hos godt trente med anfallsvis AF.

Aim: Little is known regarding atrial fibrillation (AF) triggers in endurance-trained athletes diagnosed with AF. The aim of this study is to assess whether there is a temporal relationship between training sessions and recurrent AF episodes among endurance-trained athletes with paroxysmal AF. Methods: 30 participants from the Effects of Detraining in Endurance Athletes with Paroxysmal Atrial Fibrillation study (NEXAF) were recruited to monitor AF episodes with an insertable cardiac monitor (ICM) for 5-16 weeks. They were instructed to train as usual, tracking training sessions with a training watch and a chest strap heart rate monitor. ICM-detected AF episodes were analyzed in relation to training sessions to study whether AF episodes more commonly occurred during or subsequently following training sessions. Results: Of 1458 registered AF episodes, 95 (6.7%) occurred during training, 57 (3.9%) occurred <3 hours following a training session and 1306 (89.7%) occurred >3 hours following a training session. This corresponds with event rates of 2.07, 0.46 and 0.95 per 24 hours of monitoring. Compared to >3 hours following a training session, the rate ratio for recurrent AF episodes was 2.18 for AF during training and 0.48 for AF <3 hours after training, respectively. Conclusion: The risk of recurrent AF episodes seems to be highest during training sessions in highly endurance-trained people. Within the sample group there were large individual differences highlighting the importance of individual adaptation in the management of endurance-trained individuals with paroxysmal AF.