Impact of Atrial Fibrillation and Atrial Fibrillation Therapies on Sports Performance in Athletes.

Background: It has been hypothesized that both atrial fibrillation (AF) and medications for AF, are poorly tolerated in athletes.

Objective: To determine the impact of AF and AF treatments on sports performance METHODS: An internet-based survey, initiated via StopAfib.org, queried the impact of AF and treatment modalities on sports performance, training, and symptoms. Performance, (rated in comparison to personal best), frequency of training and competition were compared prior to onset of AF symptoms versus when symptoms at worst, via paired Wilcoxon, and then similarly compared in relation to participants' AF treatments.

Results: Between 5/13/19 and 2/29/20, 1055 athletes responded, 78% male, median age 61-70 years. Most reported sports were cycling (25%) and running (20%). Development of AF was associated with declining sports performance, competition, and training frequency. Of 565 participants who detrained, 31% reported no change in symptoms, 56% reported decreased frequency, and 13% reported no further AF. Among athletes that received treatment, ablation was associated with greater improvement in sports performance than use of medications. Of 262 athletes currently on medication, 27% reported that it was completely effective, 58% partially effective, and 15% not effective. Of 653 athletes that have taken medication currently and/or in the past, 43% reported side effects, most commonly fatigue, low energy, or decreased athletic performance.

Conclusion: Athletes reported that AF was associated with worsening sports performance. Among AF treatment modalities, ablation was associated with the greater reported improvement in sports performance than use of medications which also had a high frequency of side effects.