UH Sports Cardiologist Joins Podcast to Discuss Managing Atrial Fibrillation in Athletes

Innovations in Cardiovascular Medicine & Surgery | December 2024

Bradley Lander, MD

Bradley Lander, MD, Director of the Sports Cardiology Center at University Hospitals Harrington Heart & Vascular Institute, recently joined an in-depth conversation on the American College of Cardiology Ohio’s podcast, CardiOhio, focused on the phenomenon of atrial fibrillation (AFib) in athletes. Dr. Lander shared insights about endurance sports, where research has shown that the risk of Afib is surprisingly higher in long term, endurance athletes, particularly males in their 50s-70s, than less active individuals. However, Dr. Lander makes clear this is just one of many factors to consider. For his athletic patients with Afib, he begins any discussion of AFib by reviewing other risk factors, such as alcohol, supplements, hypertension, sleep apnea, family history and medications, among others. Dr. Lander also notes that the risk of Afib at the highest levels of endurance exercise seem to be greater in men than women.

In addition, Dr. Lander and his fellow panelists discuss the possible mechanism behind AFib in certain athletes. “Part of the reason why we've seen the association between long term endurance or high-intensity exercise and atrial fibrillation is because endurance or dynamic sports, those tend to cause more chamber dilation, specifically atrial dilation,” Dr. Lander says. “The atrial dilation, the fibrosis and the remodeling all have been postulated to contribute to the increased risk of AFib in that population.” That said, AFib can occur in younger athletes as well. Dr. Lander emphasizes understanding potential contributors to the Afib sometimes requires advanced imaging with an echocardiogram and cardiac MRI.

The group also discusses whether athletes diagnosed with AFib should “detrain” from rigorous exercise or at least cut back. A clinical trial underway in Norway may provide some answers soon. They also share perspectives on a particularly challenging patient case.

Contributing Expert:
Bradley Lander, MD
Director, Sports Cardiology Center
University Hospitals Harrington Heart & Vascular Institute
Assistant Professor
Case Western Reserve University School of Medicine