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Atrial fibrillation catheter ablation in endurance athletes: systematic review and meta-analysis

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Abstract

Background

Atrial fibrillation (AF) management in endurance athletes (EA) is challenging due to the paucity of data, especially on the efficacy and safety of catheter ablation (CA). The hypothesis is that the efficacy and safety of AF CA in EA are comparable to the non-EA.

Methods

Databases from EMBASE, Medline, PubMed, and Cochrane were searched from inception through February 2023. Studies with available information on efficacy and safety profiles were included. Effect estimates from the individual studies were extracted and combined using random effect and generic inverse variance method of DerSimonian and Laird.

Results

Nine observational studies with a total of 1129 participants were identified, of whom 51% were EA. Our analysis found that rate of atrial arrhythmia (AA) recurrences following AF CA was not statistically different between EA and non-EA (RR 1.04, I2 = 57.6%, p = 0.54). The AA survival rates after a single ablation in EA was 60.2%, which improved up to 77% after multiple ablations during the follow-up period. Infrequent complication rates ranging from 0 to 7.6% were observed, with no mortality.

Conclusions

Our meta-analysis suggests that AF CA is as effective and safe in EA as in non-EA. In the future, AF CA should be considered as a first-line therapeutic choice in this patient group.

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Abbreviations

AA:

Atrial arrhythmia

AF:

Atrial fibrillation

CA:

Catheter ablation

EA:

Endurance athlete

LA:

Left atrium

PVI:

Pulmonary vein isolation

RR:

Relative risk

TIA:

Transient ischemic attack

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Author information

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA

    Narut Prasitlumkum

  2. Sparrow Hospital, Michigan State University, Lansing, MI, USA

    Nithi Tokavanich

  3. Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand

    Noppachai Siranart

  4. Department of Internal Medicine, University of Hawaii, Honolulu, HI, USA

    Witina Techasatian

  5. Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Wisit Cheungpasitporn

  6. Department of Electrophysiology, Division of Cardiovascular Medicine, University of Utah, Salt Lake, UT, USA

    Leenhapong Navaravong

  7. Division of Cardiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand

    Ronpichai Chokesuwattanaskul

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  1. Narut Prasitlumkum
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Correspondence to Ronpichai Chokesuwattanaskul.

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Prasitlumkum, N., Tokavanich, N., Siranart, N. et al. Atrial fibrillation catheter ablation in endurance athletes: systematic review and meta-analysis. J Interv Card Electrophysiol 67, 329–339 (2024). https://doi.org/10.1007/s10840-023-01574-0

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