title: My patient wants to perform strenuous endurance exercise. What's the right advice?
abstract: Prolonged strenuous endurance exercise (SEE) such as marathon running has recently been associated with potential deleterious cardiac effects, particularly increased risk of atrial fibrillation (AF). This topic is medically important due to the increasing number of participants in SEE events lasting several hours, including older people. The aim of this narrative review is to provide a summary of the evidence available on SEE and related issues such as cardiovascular mortality, AF, potential cardiac remodeling, cardiovascular events during exertion, or the need for pre-participation screening (with a special focus on beginners). This type of information can help physicians giving advice to their patients and the general public regarding safe SEE practice.
authors.affiliation: Research Institute of Hospital 12 de Octubre ('i+12'), Madrid, Spain. Electronic address: fabian.sanchis@uv.es.
authors.forename: Fabian
authors.initials: F
authors.lastname: Sanchis-Gomar
authors.affiliation: Research Institute of Hospital 12 de Octubre ('i+12'), Madrid, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Santos-Lozano
authors.affiliation: Faculty of Health and Sport Science, University of Zaragoza, Huesca, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Garatachea
authors.affiliation: Research Institute of Hospital 12 de Octubre ('i+12'), Madrid, Spain; European University, Madrid, Spain.
authors.forename: Helios
authors.initials: H
authors.lastname: Pareja-Galeano
authors.affiliation: Research Institute of Hospital 12 de Octubre ('i+12'), Madrid, Spain; European University, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Fiuza-Luces
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Joyner
authors.affiliation: Research Institute of Hospital 12 de Octubre ('i+12'), Madrid, Spain; Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Lucia
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D015444:Exercise / Q000502:physiology*; D006801:Humans; D010807:Physical Endurance / Q000502:physiology*; D010819:Physician's Role; D012307:Risk Factors; D012420:Running / Q000502:physiology* / Q000639:trends*
keywords: Arrhythmia; Atrial fibrillation; Health; Pre-participation screening; Strenuous endurance exercise; Sudden cardiac death