title: Physical activity, symptoms, medication and subjective health among veteran endurance athletes with atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation (AF) is highly prevalent, but has not previously been characterized in detail in veteran athletes. We aimed to describe physical activity (PA), symptoms, medication and subjective health in relation to AF subtype and co-morbidity among veteran cross-country skiers with AF.
  
  
  METHODS
  In total, 4952 Norwegian men and women aged 53-85 years took part in this cohort study, 2626 veteran cross-country skiers and 2326 from the general population. PA, endurance exercise, functional capacity, co-morbidity, drug use and subjective health were self-reported by questionnaires. AF was self-reported and confirmed by electrocardiograms in a medical record review.
  
  
  RESULTS
  The prevalence of self-reported AF among veteran skiers was 12.3%. AF was confirmed in 140 skiers and 118 individuals from the general population. Among skiers with AF (mean age 69 years), 52% had paroxysmal, 23% persistent and 24% permanent AF. AF was associated with poor subjective health, but 89% of the veteran skiers were physically active and 64% engaged in regular endurance exercise after the onset of AF. While 59% had experienced palpitations during the past year, 32% reported reduced functional capacity. Two out of three with AF and a CHA2DS2-VASc score ≥ 2 used oral anticoagulants (OACs).
  
  
  CONCLUSIONS
  AF was associated with poor subjective health, but the vast majority of veteran athletes engaged in regular PA and endurance exercise also after the onset of AF. This is important, as PA and exercise might reduce AF symptoms, mortality and morbidity. Many veteran skiers with AF were not optimally treated with OACs.
authors.affiliation: Department of Internal Medicine, Diakonhjemmet Hospital, Medisinsk avdeling, Diakonhjemmet sykehus, Pb 23 Vindern, 0319, Oslo, Norway. m-myrsta@online.no.
authors.forename: Marius
authors.initials: M
authors.lastname: Myrstad
authors.affiliation: Department of Internal Medicine, Diakonhjemmet Hospital, Medisinsk avdeling, Diakonhjemmet sykehus, Pb 23 Vindern, 0319, Oslo, Norway.
authors.forename: Marit
authors.initials: M
authors.lastname: Aarønæs
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Sidsel
authors.initials: S
authors.lastname: Graff-Iversen
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Inger
authors.initials: I
authors.lastname: Ariansen
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Wenche
authors.initials: W
authors.lastname: Nystad
authors.affiliation: Department of Internal Medicine, Diakonhjemmet Hospital, Medisinsk avdeling, Diakonhjemmet sykehus, Pb 23 Vindern, 0319, Oslo, Norway.|Department of Clinical Science, Kavli Research Centre for Geriatrics and Dementia, University of Bergen, Bergen, Norway.
authors.forename: Anette Hylen
authors.initials: AH
authors.lastname: Ranhoff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage; D056352:Athletes; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D015331:Cohort Studies; D004562:Electrocardiography; D015444:Exercise / Q000502:physiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D010807:Physical Endurance / Q000502:physiology*; D015995:Prevalence; D012865:Skiing / Q000502:physiology*; D011795:Surveys and Questionnaires; D014728:Veterans
chemical_list: D000925:Anticoagulants
keywords: Atrial fibrillation; Endurance exercise; Physical activity; Sports cardiology; Veteran athletes