Radiofrequency catheter ablation of atrial fibrillation in athletes referred for disabling symptoms preventing usual training schedule and sport competition.
BACKGROUND
Atrial fibrillation (AF) may occasionally affect athletes by impairing their ability to compete, and leading to noneligibility at prequalification screening. The impact of catheter ablation (CA) in restoring full competitive activity of athletes affected by AF is not known. The aim of our study was to investigate the effectiveness of CA of idiopathic AF in athletes with palpitations impairing physical performance and compromising eligibility for competitive activities.


RESULTS
Twenty consecutive competitive athletes (all males; 44.4 +/- 13.0 years) with disabling palpitations on the basis of idiopathic drug-refractory AF underwent 46 procedures (2.3 +/- 0.4 per patient) according to a prospectively designed multiprocedural CA approach that consolidates pulmonary veins (PV) isolation through subsequent steps. Preablation, effort-induced AF could be documented in 13 patients (65%) during stress ECG and significantly reduced maximal effort capacity (176 +/- 21 W), as compared with patients with no AF during effort (207 +/- 43 W, P < 0.05). At the end of CA protocol, which also included ablation of atrial flutter (AFL) in 7 patients, 18 (90.0%) patients were free of AF and two (10.0%) reported short-lasting (minutes) episodes of palpitations during 36.1 +/- 12.7 months follow-up. Compared with preablation, postablation maximal exercise capacity significantly improved (from 183 +/- 32 to 218 +/- 20 W, P < 0.02). All baseline quality of life (QoL) parameters pertinent to physical activity significantly improved (P < 0.05) at the end of CA protocol. All athletes obtained reeligibility and could effectively reinitiate sport activity.


CONCLUSIONS
AF, alone or in combination with AFL, may significantly impair maximal effort capacity thereby limiting competitive performance. Multiple PV isolation proved very effective in these patients to restore full competitive activity and allow reeligibility.
Furlanello
Francesco
F
Arrhythmia and Electrophysiology Center, IRCCS, Policlinico San Donato, University of Milan, San Donato Milanese, Milan, Italy.
Lupo
Pierpaolo
P
Pittalis
Mario
M
Foresti
Sara
S
Vitali-Serdoz
Laura
L
Francia
Pietro
P
De Ambroggi
Guido
G
Ferrero
Paolo
P
Nardi
Stefano
S
Inama
Giuseppe
G
De Ambroggi
Luigi
L
Cappato
Riccardo
R
D000328:Adult; D054874:Athletic Performance; D001281:Atrial Fibrillation / Q000534:rehabilitation* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D006233:Persons with Disabilities / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D020127:Recovery of Function; D016896:Treatment Outcome