Clinical trial NCT06844656: Understanding the Increased Risk of Atrial Fibrillation in Athletes: a Case-control Study
Official title: Understanding the Increased Risk of Atrial Fibrillation in Athletes: a Case-control Study
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Atrial Fibrillation (AF)
Keywords: Atrial Fibrillation
Athletes
Sport
Physical Activity
Exercise
Arrhythmias
Lead sponsor: University of Leicester
Sponsor class: OTHER
First posted: 2025-02-25
Enrollment: 200
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CONTROL
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Endurance athletes with and without atrial fibrillation from across the United Kingdom. Recruitment through social media, sports clubs, and word of mouth.

Brief summary: Exercise is beneficial to heart health, however, there appears to be a 'U' shaped relationship where too much exercise may increase the risk of an irregular heart rhythm, called atrial fibrillation. Endurance athletes may have up to a 2.5-fold higher risk of developing atrial fibrillation than non-athletic controls.

The mechanisms behind this increased risk of atrial fibrillation are not the well understood. It is thought to be a mixture of enlarged heart chambers, low resting heart rate, genetic predisposition and possibly scarring in the heart. In this study, the investigators will investigate the electrical activity changes in the heart, using a high-quality electrocardiogram (ECG) and relate this to changes in the heart size measured by ultrasound and MRI. Cardiopulmonary exercise testing will determine fitness (V̇O2 max) and assess the heart's electrical activity during exercise.

This will be a case-control study where athletes with and without atrial fibrillation will be recruited. The investigators hope the results of this study can improve our understanding of atrial fibrillation in athletes by associating atrial fibrillation with structural and electrical differences which may aid the prediction of future atrial fibrillation development and help guide more athlete-specific treatment pathways.


Eligibility criteria: Inclusion Criteria:

* ≥18 years of age at the time of enrolment, male and female.
* History of atrial fibrillation confirmed on ECG - either paroxysmal or persistent.
* Competitive athlete. Defined as:

  1. Competed in endurance sports with a total cumulative moderate to high intensity of \> 1500 hours.
  2. Have participated in at least one competitive event in the last 10 years.

Exclusion Criteria:

* Permanent atrial fibrillation.
* History of pre-existing cardiovascular disease :

  1. Atherosclerotic disease: previous myocardial infarction, symptomatic coronary artery disease or Peripheral peripheral arterial disease
  2. Left ventricular systolic dysfunction (EF \< 45%)
  3. Heart muscle disease: cardiomyopathies, Infiltrative diseases of the heart
  4. Complex Congenital heart disease
  5. Moderate or severe valvular disease
  6. Uncontrolled hypertension (\>180/100mmHg)

Primary outcomes:
measure: High-resolution ECG
timeFrame: At study visit
Secondary outcomes:
measure: AI classification and prediction
timeFrame: At study visit
measure: 72hr heart rate monitoring
timeFrame: At study visit
measure: Electronic stethoscope recording
timeFrame: At study visit
measure: Cardiac imaging
timeFrame: At study visit
measure: Cardiac imaging
timeFrame: At study visit
measure: Cardiac imaging
timeFrame: At study visit
measure: Cardiac imaging
timeFrame: At study visit
measure: Cardiac imaging
timeFrame: At study visit
measure: Cardiac imaging
timeFrame: At study visit
measure: Cardiac imaging
timeFrame: At study visit
measure: Cardiac imaging
timeFrame: At study visit
measure: Cardiac imaging
timeFrame: At study visit
measure: Cardiac imaging
timeFrame: At study visit
measure: Cardiopulmonary exercise testing
timeFrame: At study visit
measure: Cardiopulmonary exercise testing
timeFrame: At study visit
measure: Cardiopulmonary exercise testing
timeFrame: At study visit
measure: Cardiopulmonary exercise testing
timeFrame: At study visit
measure: Cardiopulmonary exercise testing
timeFrame: At study visit
measure: Cardiac motion recording
timeFrame: At study visit
Other outcomes:
Locations:
city: Leicester
country: United Kingdom
facility: Department of Cardiovascular Sciences. University of Leicester. Glenfield Hospital.
Study officials:
References: