title: Efficacy of radiofrequency catheter ablation in athletes with atrial fibrillation.
abstract: OBJECTIVE
  Endurance sports activities have been associated with the development of atrial fibrillation (AF). Pulmonary vein isolation (PVI) by means of radiofrequency catheter ablation has been established as an effective treatment for AF. The aim of the present study was to analyse the efficacy of AF ablation in athletes.
  
  
  RESULTS
  We compared procedural outcome and median term follow-up in 94 consecutive athletes (>3 h of sports/week for ≥ 10 years or ≥ 1500 h lifetime) who underwent PVI (94% men, 51 ± 8 years, 87% paroxysmal AF, left atrial (LA) diameter 40 ± 8 mm, mean follow-up 41 months), and 41 contemporary controls. Sixty-three per cent of athletes performed endurance sports (running, cycling, swimming, and rowing). Documented focal induction of AF and failed treatment with ≥ 1 anti-arrhythmic drug were pre-requisites for selection of ablation treatment. Patients with long-standing persistent or permanent AF or an LA diameter ≥ 55 mm were not considered for ablation. Median lifetime cumulative hours of sports was 8638 (4175-13 688) in athletes vs. 450 (280-600) in controls (P < 0.001). Other baseline characteristics except for gender (94 vs. 66% men, respectively, P < 0.001) were comparable between both groups, as was the total number of ablation procedures per patient (1.2 ± 0.5, P = 0.62). Survival analysis showed similar AF recurrence rate after a first ablation for controls and endurance athletes, though non-endurance athletes had a significantly higher AF recurrence rate (48 vs. 46 vs. 34% freedom from AF at 3 year follow-up after a single ablation, P= 0.04). Final outcome after all ablations was similar (87 vs. 84 vs. 85% freedom from AF at 3-year follow-up, P = 0.88). No other independent predictor for AF recurrence was identified.
  
  
  CONCLUSIONS
  In patients with documented focal induction of non-permanent AF and absence of structural heart disease, PVI is as effective in endurance athletes as in other patients.
authors.affiliation: Department of Cardiology,  University Hospital Gasthuisberg,  University of Leuven, Herestraat 49, B-3000 Leuven,  Belgium.
authors.forename: Pieter
authors.initials: P
authors.lastname: Koopman
authors.forename: Dieter
authors.initials: D
authors.lastname: Nuyens
authors.forename: Christophe
authors.initials: C
authors.lastname: Garweg
authors.forename: Andre
authors.initials: A
authors.lastname: La Gerche
authors.forename: Stijn
authors.initials: S
authors.lastname: De Buck
authors.forename: Lieve
authors.initials: L
authors.lastname: Van Casteren
authors.forename: Becker
authors.initials: B
authors.lastname: Alzand
authors.forename: Rik
authors.initials: R
authors.lastname: Willems
authors.forename: Hein
authors.initials: H
authors.lastname: Heidbuchel
mesh_terms: D000328:Adult; D056352:Athletes; D001281:Atrial Fibrillation / Q000401:mortality / Q000601:surgery*; D016022:Case-Control Studies; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance; D011667:Pulmonary Veins / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome