Risk of atrial fibrillation in athletes: a systematic review and meta-analysis.

Journal article


Newman, William, Parry-Williams, Gemma, Wiles, Jonathan, Edwards, Jamie, Hulbert, Sabina, Kipourou, Konstantina, Papadakis, Michael, Sharma, Rajan and O'Driscoll, Jamie 2021. Risk of atrial fibrillation in athletes: a systematic review and meta-analysis. British Journal of Sports Medicine. https://doi.org/bjsports-2021-103994
AuthorsNewman, William, Parry-Williams, Gemma, Wiles, Jonathan, Edwards, Jamie, Hulbert, Sabina, Kipourou, Konstantina, Papadakis, Michael, Sharma, Rajan and O'Driscoll, Jamie
AbstractA systematic review, meta-analysis and meta-regression were performed on selected studies to investigate the incidence of atrial fibrillation (AF) among athletes compared with non-athlete controls. Meta-analysis with heterogeneity analysis and subsequent meta-regression to model covariates were performed. The mode of exercise (endurance and mixed sports) and age were the a priori determined covariates. PubMed, MEDLINE, Science Direct, SPORTDiscus and the Cochrane library were searched. Research articles published after 1990 and before 2 December 2020 were included if they reported the number of AF cases in athletes with non-athlete (physically active or inactive) control groups, were case-control or cohort studies and if data allowed calculation of OR. The risk of developing AF was significantly higher in athletes than in non-athlete controls (OR: 2.46; 95% CI 1.73 to 3.51; p<0.001, Z=4.97). Mode of exercise and risk of AF were moderately correlated (B=0.1259, p=0.0193), with mixed sport conferring a greater risk of AF than endurance sport (B=-0.5476, p=0.0204). Younger (<55 years) athletes were significantly more likely to develop AF compared with older (≥55 years) athletes (B=-0.02293, p<0.001). Athletes have a significantly greater likelihood of developing AF compared with non-athlete controls, with those participating in mixed sport and younger athletes at the greatest risk. Future studies of AF prevalence in athletes according to specific exercise dose parameters, including training and competition history, may aid further in delineating those at risk. [Abstract copyright: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.]
KeywordsAthletes; Exercise; Sport; Atrial fibrillation
Year2021
JournalBritish Journal of Sports Medicine
PublisherBMJ Publishing Group
ISSN1473-0480
Digital Object Identifier (DOI)https://doi.org/bjsports-2021-103994
https://doi.org/10.1136/bjsports-2021-103994
Official URLhttps://bjsm.bmj.com/content/early/2021/06/30/bjsports-2021-103994
Publication dates
Print12 Jul 2021
Online12 Jul 2021
Publication process dates
Deposited14 Jul 2021
Accepted11 Jun 2021
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Open
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Taylor, K., Wiles, J., Coleman, D., Leeson, P., Sharma, R. and O'Driscoll, J. 2018. Neurohumoral and ambulatory haemodynamic adaptations following isometric exercise training in unmedicated hypertensive patients. Journal of Hypertension. https://doi.org/10.1097/HJH.0000000000001922
Cardiac autonomic and left ventricular mechanics following high intensity interval training: a randomised cross-over controlled study.
O'Driscoll, J., Wrigth, S., Taylor, K., Coleman, D., Sharma, R. and Wiles, J. 2018. Cardiac autonomic and left ventricular mechanics following high intensity interval training: a randomised cross-over controlled study. Journal of Applied Physiology. https://doi.org/10.1152/japplphysiol.00056.2018
Cardiac maladaptation in term pregnancies with preeclampsia
Buddeberg, B., Sharma, R., O'Driscoll, J., Kaelin Agten, A., Khalil, A. and Thilaganathan, B. 2018. Cardiac maladaptation in term pregnancies with preeclampsia. Pregnancy Hypertension. 13, pp. 198-203. https://doi.org/10.1016/j.preghy.2018.06.015
The safety of isometric exercise: rethinking the exercise prescription paradigm for those with stage 1 hypertension.
Wiles, J., Taylor, K., Coleman, D., Sharma, R. and O'Driscoll, J. 2018. The safety of isometric exercise: rethinking the exercise prescription paradigm for those with stage 1 hypertension. Medicine. 97 (10). https://doi.org/10.1097/MD.0000000000010105
An alternative approach to isometric exercise training prescription for cardiovascular health
Wiles, J., Goldring, N., O'Driscoll, J., Taylor, K. and Coleman, D. 2018. An alternative approach to isometric exercise training prescription for cardiovascular health. Translational Journal of the American College of Sports Medicine. 3 (2), pp. 10-18. https://doi.org/10.1249/TJX.0000000000000052
What really matters about teacher education at Cathedrals Group Universities: volume 2 the case studies
Bowie, R. A., Casson, A., Hulbert, S., Benton, M., Holt, J., James, M., Jarvis, P., McGuire, L., Podesta, E. and Stone, G. 2018. What really matters about teacher education at Cathedrals Group Universities: volume 2 the case studies. Canterbury Canterbury Christ Church University.
What really matters about teacher education at Cathedrals Group Universities: volume 1 final report
Bowie, R. A., Casson, A. and Hulbert, S. 2018. What really matters about teacher education at Cathedrals Group Universities: volume 1 final report. Canterbury Canterbury Christ Church University.
Baseline mitral regurgitation predicts outcome in patients referred for dobutamine stress echocardiography
O'Driscoll, J., Gargallo-Fernandez, P., Araco, M., Perez-Lopez, M. and Sharma, R. 2017. Baseline mitral regurgitation predicts outcome in patients referred for dobutamine stress echocardiography. International Journal of Cardiovascular Imaging. https://doi.org/10.1007/s10554-017-1163-6
Blood pressure responses to isometric exercise: safety considerations for exercise prescription
Wiles, J., Taylor, K., Coleman, D., Sharma, R. and O'Driscoll, J. 2017. Blood pressure responses to isometric exercise: safety considerations for exercise prescription.
Ambulatory blood pressure responses to home-based isometric exercise training in pre-hypertensive males
Taylor, K., Wiles, J., Coleman, D., Sharma, R. and O'Driscoll, J. 2017. Ambulatory blood pressure responses to home-based isometric exercise training in pre-hypertensive males.
Cardiac autonomic modulation and high intensity interval training in physically inactive men
O'Driscoll, J., Wright, S., Taylor, K., Coleman, D. and Wiles, J. 2017. Cardiac autonomic modulation and high intensity interval training in physically inactive men.
A higher effort-based paradigm in physical activity and exercise for public health: making the case for a greater emphasis on resistance training
Steele, J., Fisher, J., Skivington, M., Dunn, C., Arnold, J., Tew, G., Batterham, A., Nunan, D., O'Driscoll, J., Mann, S., Beedie, C., Jobson, S., Smith, D., Vigotsky, A., Phillips, S., Estabrooks, P. and Winett, R. 2017. A higher effort-based paradigm in physical activity and exercise for public health: making the case for a greater emphasis on resistance training. BMC Public Health. https://doi.org/10.1186/s12889-017-4209-8
Continuous cardiac autonomic and haemodynamic responses to isometric exercise in pre-hypertensive males
Taylor, K., Wiles, J., Coleman, D., Sharma, R. and O'Driscoll, J. 2017. Continuous cardiac autonomic and haemodynamic responses to isometric exercise in pre-hypertensive males. Medicine & Science in Sports & Exercise (MSSE). https://doi.org/10.1249/MSS.0000000000001271
Acute cardiac functional and mechanical responses to isometric exercise in pre-hypertensive males
O'Driscoll, J., Taylor, K., Wiles, J., Coleman, D. and Sharma, R. 2017. Acute cardiac functional and mechanical responses to isometric exercise in pre-hypertensive males. Physiological Reports. https://doi.org/10.14814/phy2.13236
Body mass index mortality paradox in chronic kidney disease patients with suspected cardiac chest pain
O'Driscoll, J., Slee, A. and Sharma, R. 2017. Body mass index mortality paradox in chronic kidney disease patients with suspected cardiac chest pain. Journal of Cachexia, Sarcopenia and Muscle Clinical Reports. 2 (1).
Strongman training – Needs analysis and integration into strength and conditioning programming: part 2.
McManus, A., O'Driscoll, J., Coleman, D. and Wiles, J. 2016. Strongman training – Needs analysis and integration into strength and conditioning programming: part 2. Professional Strength & Conditioning. 44, pp. 7-15.
Strongman training – a rationale for its inclusion in strength & conditioning: part 1
McManus, A., Wiles, J., Coleman, D. and O'Driscoll, J. 2016. Strongman training – a rationale for its inclusion in strength & conditioning: part 1. Professional Strength & Conditioning. 43, pp. 7-18.
Design, development and validity testing of the Gang Affiliation Risk Measure (GARM)
Raby, C., Jones, F., Hulbert, S. and Stout, J. 2017. Design, development and validity testing of the Gang Affiliation Risk Measure (GARM). Journal of Forensic Psychiatry & Psychology. https://doi.org/10.1080/14789949.2017.1324578
Museum object handling: a health promoting community-based activity for dementia care
Camic, P., Hulbert, S. and Kimmel, J. 2017. Museum object handling: a health promoting community-based activity for dementia care. Journal of Health Psychology. https://doi.org/10.1177/1359105316685899
Acute cardiac autonomic responses to an incremental isometric exercise test in pre-hypertensive males
Taylor, K., Wiles, J., Coleman, D., Sharma, R. and O'Driscoll, J. 2016. Acute cardiac autonomic responses to an incremental isometric exercise test in pre-hypertensive males.
Transthoracic echocardiography provides important long-term prognostic information in selected patients undergoing endovascular abdominal aortic repair
O'Driscoll, J., Bahia, S., Gravina, A., Di Fino, S., Thompson, M., Karthikesalingam, A., Holt, P. and Sharma, R. 2016. Transthoracic echocardiography provides important long-term prognostic information in selected patients undergoing endovascular abdominal aortic repair. Circulation Cardiovascular Imaging. https://doi.org/10.1161/CIRCIMAGING.115.003557
Reverse left ventricular remodelling - effect of cardiac rehabilitation exercise training in myocardial infarction patients with preserved ejection fraction
McGregor, G., Gaze, D., Oxborough, D., O'Driscoll, J. and Shave, R. 2015. Reverse left ventricular remodelling - effect of cardiac rehabilitation exercise training in myocardial infarction patients with preserved ejection fraction. European Journal of Physcial and Rehabilitation Medicine. 52 (3), pp. 370-378.
The Character Development Project Final Report
Cooling, T., Hulbert, S., Thomas, C. and Gregory, P. 2016. The Character Development Project Final Report. Church of England Education Office.
Museum objects, aesthetic stimulation and psychological wellbeing in early to middle stages of dementia
Camic, P. and Hulbert, S. 2016. Museum objects, aesthetic stimulation and psychological wellbeing in early to middle stages of dementia.
Examining the effectiveness of the theory of planned behaviour in explaining exercise intention and behaviour during pregnancy: a meta-analysis
De Vivo, M., Hulbert, S., Mills, H. and Uphill, M. 2016. Examining the effectiveness of the theory of planned behaviour in explaining exercise intention and behaviour during pregnancy: a meta-analysis. Journal of Reproductive and Infant Psychology. https://doi.org/10.1080/02646838.2015.1118022
The prognostic value of dobutamine stress echocardiography amongst British Indian Asian and Afro-Caribbean patients: a comparison with European white patients
O'Driscoll, J., Rossato, C., Gargallo-Fernandez, P., Araco, M., Giannoglou, D., Sharma, S. and Sharma, R. 2015. The prognostic value of dobutamine stress echocardiography amongst British Indian Asian and Afro-Caribbean patients: a comparison with European white patients. Cardiovascular Ultrasound. 13 (36). https://doi.org/10.1186/s12947-015-0028-1
Non-invasive assessment of the autonomic nervous system
O'Driscoll, J. and Sharma, R. 2015. Non-invasive assessment of the autonomic nervous system. International Journal of Clinical Therapeutics and Diagnosis. 3 (3), pp. 85-91.
Differing autonomic responses to dobutamine stress in the presence and absence of myocardial ischaemia
Sharma, R., O'Driscoll, J., Saha, A., Sritharan, M., Sutton, R. and Rosen, S. 2015. Differing autonomic responses to dobutamine stress in the presence and absence of myocardial ischaemia. The Journal of Physiology. 593 (9), pp. 2171-2184. https://doi.org/10.1113/JP270063
The safety and clinical usefulness of dobutamine stress echocardiography among octogenarians
O'Driscoll, J., Marciniak, A., Ray, K., Schmid, K., Smith, R. and Sharma, R. 2014. The safety and clinical usefulness of dobutamine stress echocardiography among octogenarians. Heart. 2014 (100), pp. 1001-1007. https://doi.org/10.1136/heartjnl-2013-305229
The implementation of problem based learning styles to teach the Coach-Athlete relationship to undergraduate Sport and Exercise Science students
Rossato, C. and O'Driscoll, J. 2013. The implementation of problem based learning styles to teach the Coach-Athlete relationship to undergraduate Sport and Exercise Science students. International Journal of Sport Studies. 3, pp. 859-864.
A retrospective observational study of the effectiveness of paliperidone palmitate on acute inpatient hospitalization rates
Bressington, D., Stock, J., Hulbert, S. and MacInnes, D. 2015. A retrospective observational study of the effectiveness of paliperidone palmitate on acute inpatient hospitalization rates. International Clinical Psychopharmacology. 30 (4), pp. 230-236. https://doi.org/10.1097/YIC.0000000000000077
Viewing art on a tablet computer: a wellbeing intervention for people with dementia and their caregivers
Tyack, C., Camic, P., Herron, A. and Hulbert, S. 2015. Viewing art on a tablet computer: a wellbeing intervention for people with dementia and their caregivers. Journal of Applied Gerontology. https://doi.org/10.1177/0733464815617287
Museum activities in dementia care: using visual analog scales to measure subjective wellbeing
Johnson, J., Culverwell, A., Hulbert, S., Roberton, M. and Camic, P. 2015. Museum activities in dementia care: using visual analog scales to measure subjective wellbeing. Dementia: The International Journal for Social Research and Practice. https://doi.org/10.1177/1471301215611763
The impact of viewing and making art on verbal fluency and memory in people with dementia in an art gallery setting
Young, R., Tischler, V., Hulbert, S. and Camic, P. 2015. The impact of viewing and making art on verbal fluency and memory in people with dementia in an art gallery setting. Psychology of Aesthetics, Creativity, and the Arts. https://doi.org/10.1037/aca0000030
The unitary ability of IQ and indexes in WAIS-IV
Orsini, A., Pezzuti, L. and Hulbert, S. 2015. The unitary ability of IQ and indexes in WAIS-IV. European Journal of Psychological Assessment. https://doi.org/10.1027/1015-5759/a000306
Group singing and young people’s psychological well-being
Hinshaw, T., Clift, S., Hulbert, S. and Camic, P. 2015. Group singing and young people’s psychological well-being. International Journal of Mental Health Promotion. https://doi.org/10.1080/14623730.2014.999454
Examining the effectiveness of the Theory of Planned Behaviour in predicting exercise intention and behaviour during pregnancy: Preliminary findings from a random effects meta-analysis
De Vivo, M., Hulbert, S., Mills, H. and Uphill, M. 2014. Examining the effectiveness of the Theory of Planned Behaviour in predicting exercise intention and behaviour during pregnancy: Preliminary findings from a random effects meta-analysis.
The unitary ability of IQ in the WISC-IV and its computation
Orsini, A., Pezzuti, L., Hulbert, S., Sapienza University of Rome and Canterbury Christ Church University 2014. The unitary ability of IQ in the WISC-IV and its computation. Personality and Individual Differences. 69, pp. 173-175. https://doi.org/10.1016/j.paid.2014.05.023
Enhanced physical health screening for people with severe mental illness in Hong Kong: results from a one-year prospective case series study
Bressington, D., Mui, J., Hulbert, S., Cheung, E., Bradford, S. and Gray, Richard 2014. Enhanced physical health screening for people with severe mental illness in Hong Kong: results from a one-year prospective case series study. BMC Psychiatry. 14 (57). https://doi.org/10.1186/1471-244X-14-57
The influence of parents' education in the Italian standardization sample of the WISC-III
Cianci, L., Orsini, A., Hulbert, S. and Pezzuti, L. 2013. The influence of parents' education in the Italian standardization sample of the WISC-III. Learning and Individual Differences. 28, pp. 47-53. https://doi.org/10.1016/j.lindif.2013.09.009
Differing autonomic responses to dobutamine stress in the presence and absence of myocardial ischaemia
Sharma, R., O'Driscoll, J., Bromley, P., Sritharan, M. and Rosen, S. 2008. Differing autonomic responses to dobutamine stress in the presence and absence of myocardial ischaemia.
Dobutamine stress echocardiography accurately detects significant coronary artery disease in Indian Asians living in the United Kingdom
Itam, S., O'Driscoll, J., Milad, E. and Sharma, R. 2008. Dobutamine stress echocardiography accurately detects significant coronary artery disease in Indian Asians living in the United Kingdom.
The effects of a high-protein, paleolithic-type diet on body composition and exercise performance in amateur mixed martial artists
Slee, A., O'Driscoll, J., Burnet, S., Hughes, G. and Chen, M. 2009. The effects of a high-protein, paleolithic-type diet on body composition and exercise performance in amateur mixed martial artists.
Subjective global assessment is an independent predictor of cardiac ischaemia in patients with mild chronic kidney disease
Aldous, G., Sharma, R., O'Driscoll, J., Ashby, D., Tarn, F. and Choi, P. 2010. Subjective global assessment is an independent predictor of cardiac ischaemia in patients with mild chronic kidney disease.
A National Health Service hospital's cardiac rehabilitation programme: a qualitative analysis of provision
O'Driscoll, J., Shave, R. and Cushion, C. 2007. A National Health Service hospital's cardiac rehabilitation programme: a qualitative analysis of provision. Journal of Clinical Nursing. 16 (10), pp. 1908-1918. https://doi.org/10.1111/j.1365-2702.2007.01815.x
Inequalities in the training and implementation of cardiac rehabilitation in the United Kingdom
O'Driscoll, J. and Sharma, R. 2009. Inequalities in the training and implementation of cardiac rehabilitation in the United Kingdom. in: Bennington, E. (ed.) Horizons in World Cardiovascular Research Hauppauge, New York Nova Science Publishers.