Endurance sport enthusiasts over 40 years of age who develop the heart condition atrial fibrillation may be at an increased risk of developing stroke.
This is the conclusion drawn from analysis of the responses of more than 1,000 professional and amateur endurance athletes carried out by Leicester researcher, Dr Susil Pallikadavath, led by Professor Gerry McCann and Doctor Anvesha Singh at the NIHR Leicester BRC.
The study was published in May 2023 in the Clinical Journal of Sports Medicine.
Dr Susil Pallikadavath, a NIHR Academic Clinical Fellow in Cardiology at the University of Leicester, and lead author of the paper, said: “It will be surprising to many people that existing research tells us that endurance athletes are more likely to develop atrial fibrillation, a heart condition characterised by irregular heartbeat, than the general population.
“Most commonly, people with the condition may experience periods of high heart rates.
“For most people atrial fibrillation isn’t dangerous in itself, but it can cause a blood clot to form in the heart which can then lead to a stroke.
“We estimate who’s at greatest risk of a stroke by using a scoring system called CHA2-DS2-Vasc, which takes in to account age, sex, blood pressure, heart disease and previous stroke . Athletes generally would be deemed to be at a low risk of a stroke using this score, but we know that they can also display changes in their heart such as a slow heart beat and enlarged chambers which are not captured by these scores. These factors may increase athletes risk of stroke with atrial fibrillation but we need a lot more data to be certain.”
In this survey of 1,002 people from 41 countries around the world, 190 of the athletes reported a history of Atrial Fibrillation. Of the 1,002 individuals, 26 reported having had a stroke.
When the team examined the responses in detail, they saw that atrial fibrillation was associated with stroke in these athletes: even among those with a low CHA2-DS2-Vasc score, who would be deemed at low risk by this measure alone.
Dr Pallikavardath concluded: “The results of our survey suggest that veteran endurance athletes who develop Atrial Fibrillation may be at an increased risk of stroke, and this may not be detected by the standard risk scoring system. We suggest that larger studies should be carried out to understand this association in athletes compared to the general population.”
The researchers recently took part in a short video with Global Cycling Network about their research, in which two endurance cyclists underwent scans of their hearts to better understand the impact of long-term endurance sports on their own heart volume and rhythms.
You can watch this short video here.