Atrial fibrillation ablation in Athletes vs. non-Athletes: 5-year
experience of a single Italian third-level center.
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.