A growing body of literature supports an association between long-term endurance exercise and the development of atrial fibrillation (AF). Given the benefits of lifelong exercise, a better understanding of this association is critical to allow healthcare providers to counsel aging exercisers on the proper "dose" of exercise to maximize health benefits but minimize AF risk. The current study examines the relationship between specific aspects of training volume and intensity and the occurrence of AF among older runners in order to better understand what aspects of endurance exercise may contribute to the development of AF. The study was an Internet-based survey of endurance training and health characteristics of runners 35 years of age and older. A total 2819 runners participated and 69 (2.4%) reported a current or prior diagnosis of AF. Among "traditional" risk factors, runners reporting AF were older, more likely to be male, and had higher rates of hypertension and diabetes. Among training characteristics, only accumulated years of training was associated with AF. In contrast, average weekly mileage, training pace, and days of training per week were not associated with AF. In a multivariable analysis that included chronologic age, sex, diabetes, and hypertension, accumulated years of training remained significantly associated with the report of AF. These findings suggest that the relationship between chronic endurance exercise and AF is dependent on the accumulated training duration but does not appear to be influenced by specific training characteristics such as frequency or intensity of endurance exercise. Further confirmation of these relationships may help healthcare providers counsel exercisers on optimal training habits and identify endurance athletes who are at risk for the development of AF.
Keywords: atrial fibrillation; exercise; running.