Sole of a shoe sneaker on a person on a walk in the park, showing a heart.

What to Know About AFib and Athletes

Atrial fibrillation, or afib, is the most common abnormal heartbeat pattern (arrhythmia) in the world. Experts believe that about 3 in every 100 people have had afib at some point. It is also the most common arrhythmia in athletes, especially male endurance athletes.1

What is afib?

In afib, the upper chambers of the heart “fibrillate,” or twitch. This causes an especially fast or irregular heartbeat and prevents blood from properly flowing through the body.2

A person in afib may feel as though their heart is racing or skipping beats. Because blood does not flow through the heart properly, afib can increase the risk of blood clots and heart failure. Those blood clots can travel to places like the brain and cause a stroke.3

Many factors can increase your risk of afib. These include:3

  • Older age
  • Caffeine, nicotine, illicit drug, or alcohol use
  • Changes in levels of electrolytes like magnesium, potassium, or sodium
  • Family history of afib
  • Thyroid disease

What causes afib in athletes?

Exercise is 1 of the best things you can do for your heart health. It also helps reduce your risk of metabolic diseases like high blood pressure, high cholesterol, and diabetes. It can even help improve your mood and mental health.1

However, there is an interesting pattern by which athletes are most likely to develop afib. At 1 extreme, people who exercise very rarely are at higher risk for heart conditions like afib. At the other extreme, people who exercise very intensely also are at higher risk for afib. But people who exercise moderately improve their heart health and are at lower risk for heart conditions.4

Experts have a few theories about why endurance athletes – those who engage in long, high-intensity workouts – are at higher risk for afib. For example, to keep up with very intense exercise, the heart chambers may change their shape. This shape change may affect how the heart cells send messages and cause abnormal patterns like afib.4

How is afib in athletes diagnosed?

If you are experiencing symptoms that may stem from afib, your doctor will likely order an electrocardiogram (EKG or ECG). This is a quick, noninvasive test in which wires are connected to your chest and body with stickers. These wires send information to a machine that charts how signals are sent through your heart cells. This gives your doctor a visual image of your heart rhythm.2

EKGs only capture 10 seconds of your heart rhythm. Because afib can come and go, and EKG may miss it. If this happens, your doctor may recommend a Holter monitor. This is a small monitor that can track your heart rhythm for a day or more.2

How is afib in athletes treated?

Treatment of afib in athletes is similar to treatment in nonathletes. Your doctor may recommend certain medicines that can make the rate or rhythm of your heart more normal.4

Your doctor also may recommend a slightly more invasive procedure called a catheter ablation. This is where a small catheter is threaded through the veins to the heart. Ablation is the process of scarring certain areas of the heart. This helps prevent irregular rhythms.4

Most people do not exercise at the intensity that increases the risk of afib. Overall, the benefits of exercise greatly outweigh this possible risk. But if you are experiencing a racing heart that does not slow down or if you feel your heart is often skipping beats, you may have afib. Tell your doctor about these symptoms right away.4

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