Some studies have suggested that vigorous exercise may be associated with an increased risk of atrial fibrillation (AF), but the frequency of its incidence in elite athletes is not known. The objective of this study is to evaluate the risk of atrial fibrillation associated with heavy exercise in elite athletes.

This retrospective observational cohort study included a total of 6,813 Spanish elite athletes. The study involved athletes from most sports disciplines who were on national teams and competed and competed in major international events. All participants underwent at least one cardiologic evaluation, including an assessment of AF diagnosis. The primary outcome of this study was the diagnosis of AF.

During a study of 20 years, only 21 of 6,813 athletes included in the study had AF. Multivariate analysis suggested that the higher risk of AF was correlated with increasing values of age (OR 1.07), years of competition (OR 1.14), and left anteroposterior atrial diameter (OR 1.121).

The research concluded that elite athletes were not at a higher risk of atria fibrillation, even if they underwent high-endurance training. However, slight associations were reported between athlete age, years of competition, left anteroposterior atrial diameter, and the risk of atrial fibrillation.