No impact of sports practice before or after atrial fibrillation ablation on procedure efficacy in athletes: a case-control study

Europace. 2019 Dec 1;21(12):1833-1842. doi: 10.1093/europace/euz231.

Abstract

Aims: Limited data exist on the efficacy of catheter ablation (CA) for sport-related atrial fibrillation (AF). Impact of sports practice resumption post-CA remains unknown. We aimed to determine AF CA efficacy in athletes vs. non-athletes, and to assess the impact of sport practice resumption.

Methods and results: From 1153 first-time AF CA performed between 2009 and 2017, 73 athletes were matched with 73 sedentary patients based on age, sex, and closest CA procedure date. Athletes were defined as performing ≥6 h/week of vigorous sports to achieve ≥2000 h accumulated lifetime sports activity. They were mostly males (93.2%) with a mean age of 55 ± 9.8 years. Before CA, athletes practiced 10.2 ± 3.9 h/week of vigorous exercise vs. 4.6 ± 3.4 after CA. Within first year after CA, physical activity was stopped in 12 (16.4%) athletes, lowered in 45 (61.9%), and resumed at same intensity in 16 (21.9%). Athletes and non-athletes suffered from same AF recurrence rates during 5-year follow-up after CA: 38 (52.0%) vs. 35 (47.9%), respectively [adjusted hazard ratio (HR) on age, body mass index (BMI), obstructive sleep apnoea (OSA), and reduced left ventricular ejection fraction (LVEF), 1.17 (0.70-1.97, P = 0.54)]. No significant impact of physical activity resumption status was found regarding AF recurrence rates at 1-year and beyond (P = 0.60). Procedure effectiveness was significantly lower in athletes with non-paroxysmal AF [adjusted on age, BMI, reduced LVEF, and OSA HR 2.36 (confidence interval 1.19-4.70), P = 0.01].

Conclusion: Sports practice before and after CA has no significant impact on AF recurrence rates in athletes within 5-year after AF CA.

Keywords: Athletes; Atrial fibrillation; Atrial fibrillation recurrence; Catheter ablation; Sport practice resumption.

MeSH terms

  • Athletes*
  • Atrial Fibrillation / diagnostic imaging
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery*
  • Atrial Remodeling*
  • Case-Control Studies
  • Catheter Ablation*
  • Echocardiography
  • Endurance Training
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Recurrence
  • Return to Sport*
  • Risk Factors
  • Sedentary Behavior
  • Stroke Volume
  • Treatment Outcome
  • Ventricular Remodeling*