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Atrial fibrillation ablation in Athletes vs. non-Athletes: 5-year experience of a single Italian third-level center.
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  • Francesca Pizzamiglio,
  • Maria Antonietta Dessanai,
  • Claudio Tondo,
  • Rita Sicuso,
  • Gaetano Fassini,
  • Alice Bonomi,
  • Antonio Dello Russo,
  • Daniele Andreini,
  • Paolo Zeppilli,
  • Sfefania Isabella Riva
Francesca Pizzamiglio
Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico

Corresponding Author:francesca.pizzamiglio@cardiologicomonzino.it

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Maria Antonietta Dessanai
Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico
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Claudio Tondo
Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico
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Rita Sicuso
Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico
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Gaetano Fassini
Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico
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Alice Bonomi
Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico
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Antonio Dello Russo
AOU Ospedali Riuniti di Ancona
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Daniele Andreini
Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico
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Paolo Zeppilli
Università Cattolica del Sacro Cuore Sede di Roma
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Sfefania Isabella Riva
Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico
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Abstract

Introduction. Few data exist about effectiveness of atrial fibrillation (AF) catheter ablation (CA) in athletes and feasibility of resuming vigorous exercise afterwards. Aims of our study were to analyze the efficacy and safety of AF CA in athletes, to compare AF CA outcomes in athletes vs Non-Athletes (NA) and to evaluate the feasibility of resuming vigorous exercise. We additionally analyze the outcome of patients that underwent concomitant cavo-tricuspid isthmus (CTI) CA. Methods and results. From January 2015 to October 2019, 38 athletes were retrospectively matched with 38 NA that underwent first time AF CA. After a median follow-up of 787 days, 62.5% of athletes were free from recurrences after one CA procedure and mostly without antiarrhythmic drugs (87%). Seven athletes underwent a redo procedure and all of them were then free of recurrences with an overall freedom from recurrences of 84%. No major complications were observed. After the first year of follow-up, athletes had a 48% reduced risk of recurrences than NA [adjusted hazard ratio (HR) on antiarrhythmic drugs, LA volume and AF subtype, HR 0.52]. Athletes that underwent also CTI ablation showed a positive trend in terms of freedom from recurrences (50% vs 21%). Most (72%) of the athletes resumed vigorous exercise after at least 3 months from the CA. Conclusion. AF CA is a safe and efficient therapeutic option in athletes and it should be considered instead of drugs to early resume competitive sport activity. Concomitant CTI ablation may have a favorable role.