Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, USA.
Am J Cardiol. 2012 Jan 15;109(2):296-302. doi: 10.1016/j.amjcard.2011.08.041. Epub 2011 Oct 22.
Atrial fibrillation (AF) is the most common arrhythmia in the athletic community and is more frequently observed in middle-aged than in young athletes. Recent studies have shown that the prevalence of AF is higher in individuals who are involved in intense short-term training and long-term sports participation compared to general population of the same age although clear evidence about the causal relation between these conditions is lacking. Anatomic adaptation, chronic systemic inflammation, and alterations in the autonomic system are all possible explanations for the increased prevalence of AF in athletes. AF associated with sports is usually paroxysmal with occasional crisis. Treatment of AF in this population can be challenging because of a lack of randomized trials and clear guidelines. Antiarrhythmic agents are usually the preferred choice of drugs. Several reports of catheter ablation have demonstrated encouraging results. Further studies are needed to understand the mechanism of autonomic hyperactivation and its interaction with the atrial substrate to develop new ablation strategies in this group of patients. Also, studies on the intensity and duration of exercise that would negate the proarrhythmic cardiac effects are also warranted.
心房颤动（AF）是运动人群中最常见的心律失常，在中年人群中比在年轻运动员中更为常见。最近的研究表明，与同龄人群相比，参与高强度短期训练和长期运动的个体中 AF 的患病率更高，尽管这些情况之间存在因果关系的明确证据尚缺乏。解剖适应、慢性全身炎症和自主神经系统的改变都可能是运动员中 AF 患病率增加的原因。与运动相关的 AF 通常是阵发性的，偶尔会出现危机。由于缺乏随机试验和明确的指南，该人群中 AF 的治疗可能具有挑战性。抗心律失常药物通常是首选药物。一些导管消融的报告显示出令人鼓舞的结果。需要进一步的研究来了解自主神经兴奋的机制及其与心房基质的相互作用，以开发该组患者的新消融策略。此外，还需要研究运动的强度和持续时间，以消除致心律失常的心脏效应。
