Is the Risk of Atrial Fibrillation Higher in Athletes Than in the General Population? A Systematic Review and Meta-analysis

Aims: The aim of this study was to examine by a systematic literature review and meta-analysis whether the risk of atrial fibrillation (AF) is higher in athletes compared with not athletes.

Methods And Results: A comprehensive systematic search was conducted for case-control studies that examined cases of AF or atrial flutter in athletes vs. controls. Extracted data from the eligible studies were meta-analysed using fixed effects model. Six case-control studies were eligible for meta-analysis. A total of 655 athletes and 895 controls were compared. Mean age was 51+/-9 years and 93% were men. There were 147 (23%) vs. 116 (12.5%) cases of AF among athletes compared with controls. The overall risk of AF was significantly higher in athletes than in controls with odds ratio (95% confidence interval)=5.29 (3.57-7.85), P=0.0001, and Z-score=8.08. For heterogeneity, the calculated chi2=2.92, P=0.633, and I2=0% were not significant.

Conclusion: The risk of AF is significantly higher in athletes compared with not athletes. However, this finding should be confirmed further in large-scale prospective longitudinal studies.