Stergiou Dimitrios, Duncan Edward
MSc Sports Cardiology, Cardiology Clinical Academic Group, St George's, University of London, London, UK.
Department of Cardiology, The Bristol Heart Institute, Bristol, UK.
Curr Treat Options Cardiovasc Med. 2018 Oct 26;20(12):98. doi: 10.1007/s11936-018-0697-9.
A complex relationship exists between exercise and atrial fibrillation (AF). Moderate exercise reduces AF risk whereas intense strenuous exercise has been shown to increase AF burden. It remains unclear at which point exercise may become detrimental. Overall, endurance athletes remain at lower cardiovascular risk and experience fewer strokes. The questions that arise therefore are whether AF is an acceptable byproduct of strenuous exercise, whether athletes who experience AF should be told to reduce exercise volume and how should they be managed. This review aims to critically review the literature and advise on how best to manage athletes with AF.
Emerging evidence suggests that female athletes may exhibit lower risk of AF, but data is limited in female endurance athletes. AF is more prevalent in endurance athletes, particularly men and those who competed at a young age. Data is lacking in females and ethnic minorities. Current evidence suggests that treatment options for AF in athletes are similar to those used in the general population; however, medical therapy may be poorly tolerated. Catheter ablation is effective and can allow return to full competition.
运动与心房颤动（AF）之间存在复杂的关系。适度运动可降低房颤风险，而剧烈运动已被证明会增加房颤负担。目前尚不清楚运动在哪个节点可能变得有害。总体而言，耐力运动员的心血管风险较低，中风发生率也较低。因此产生的问题是，房颤是否是剧烈运动可接受的副产品，经历房颤的运动员是否应被告知减少运动量以及应如何对他们进行管理。本综述旨在批判性地回顾文献，并就如何最好地管理患有房颤的运动员提供建议。
新出现的证据表明，女性运动员患房颤的风险可能较低，但女性耐力运动员的数据有限。房颤在耐力运动员中更为普遍，尤其是男性和那些年轻时就参加比赛的人。女性和少数族裔的数据较少。目前的证据表明，运动员房颤的治疗选择与普通人群相似；然而，药物治疗的耐受性可能较差。导管消融是有效的，并且可以允许运动员恢复全面比赛。
