title: Atrial fibrillation in highly trained endurance athletes - Description of a syndrome.
abstract: Atrial fibrillation (AF) is the most common heart arrhythmia, the risk of which typically increases with age. This condition is commonly associated with major cardiovascular diseases and structural heart damage, while it is rarely observed in healthy young people. However, increasing evidence indicates that paroxysmal AF can also onset in young or middle-aged and otherwise healthy endurance athletes (e.g., cyclists, runners and cross-country skiers). Here we review the topic of AF associated with strenuous endurance exercise (SEE), for example cycling, running and cross-country skiing, especially at a competitive level, and we propose the definition of a new syndrome based on the accumulating data in the literature: SEE-related AF under the acronym of 'PAFIYAMA' ('paroxysmal AF in young and middle-aged athletes'). Special emphasis is given to the proper differentiation of PAFIYAMA from 'classical AF' regarding pathophysiology, diagnosis and medical management.
authors: Department of Physiology, Faculty of Medicine, University of Valencia and Fundación Investigación Hospital Clínico Universitario de Valencia, Instituto de Investigación INCLIVA, Valencia, Spain; Research Institute Hospital 12 de Octubre ('i+12'), Madrid, Spain. Electronic address: fabian.sanchis@uv.es.
authors: Fabian
authors: F
authors: Sanchis-Gomar
authors: Research Institute Hospital 12 de Octubre ('i+12'), Madrid, Spain.
authors: Carme
authors: C
authors: Perez-Quilis
authors: Section of Clinical Biochemistry, University of Verona, Verona, Italy.
authors: Giuseppe
authors: G
authors: Lippi
authors: Emergency Department, Academic Hospital of Parma, Parma, Italy.
authors: Gianfranco
authors: G
authors: Cervellin
authors: Faculty of Health, School of Medicine, University Witten/Herdecke, Hagen, Germany.
authors: Roman
authors: R
authors: Leischik
authors: EFSMA and German Fed. Sports Medicine, Remscheid, Germany.
authors: Herbert
authors: H
authors: Löllgen
authors: Faculty of Medicine, Physical Education and Sports Section, University of Zaragoza, Zaragoza, Spain.
authors: Enrique
authors: E
authors: Serrano-Ostáriz
authors: Research Institute Hospital 12 de Octubre ('i+12'), Madrid, Spain; European University of Madrid, Madrid, Spain.
authors: Alejandro
authors: A
authors: Lucia
mesh_terms: D000367:Age Factors; D056352:Athletes; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D010807:Physical Endurance / Q000502:physiology*; D012307:Risk Factors; D012737:Sex Factors; D013577:Syndrome; D020257:Ventricular Remodeling / Q000502:physiology*
keywords: Arrhythmias; Endurance; Exercise; Fibrosis; Left atrium; Remodeling