Atrial Electromechanical Function in Endurance Athletes With and Without Atrial Fibrillation

NCT ID: NCT03305744

Last Updated: 2020-11-03

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 34 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2018-01-30
• Study Completion Date: 2021-08-31

Brief Summary

This study evaluates cardiac structure and function differences between healthy endurance trained athletes with atrial fibrillation and healthy age matched endurance trained athletes without atrial fibrillation. It is hypothesized that despite having similar structural adaptations of the heart (due to endurance training), athletes with atrial fibrillation display will impaired heart functional measures compared to endurance athletes without atrial fibrillation.

Detailed Description

Regular physical activity, including vigorous exercise, lowers cardiovascular risk factors, including the risk of developing Atrial Fibrillation (AF), one of the most commonly diagnosed types of arrhythmias. Paradoxically, despite the cardioprotective effects of exercise, middle aged endurance athletes are at 5 fold risk of developing AF compared to active individuals. Long standing endurance training induces significant changes to the heart- collectively known as the 'athlete's heart.' While these changes may be beneficial for performance, they may be conducive in promoting the risk of AF in this cohort. The aim of this study is to compare cardiac structure and function in endurance athletes diagnosed with AF (n=17) and in healthy aged matched endurance athletes (n=17). Male subjects between ages 45 and 65 years old with a long-standing history of endurance training and competition will be recruited. Heart structure and function will be compared at rest and during submaximal exercise. Participants will also complete fitness assessments and questionnaires that characterize their lifetime involvement in exercise training. This study will address the gap in the literature regarding the interaction of endurance training and AF risk.

Conditions

Paroxysmal Atrial Fibrillation

Study Design

• Observational Model Type: CASE_CONTROL
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

Endurance Athlete with Atrial Fibrillation

These are middle-aged athletes who are diagnosed with paroxysmal Atrial Fibrillation in the last 4 years, but are otherwise free of disease.

No interventions assigned to this group

Endurance Athlete without Atrial Fibrillation

These are middle-aged athletes who will serve as our control group- they have not been diagnosed with AF or any other disease.

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

ALL participants:

• endurance athlete (cyclist, runner, triathlete or other) who participate in vigorous year-round training of 4-6 hours per week for a minimum of 20 years
• participation in atleast one major competition per year (marathon/triathlon/endurance competition)
• sinus rhythm during all assessments

• diagnosed with lone paroxysmal AF in the last 4 years
• able to verify diagnosis (ECG or Holter verification/proof of diagnosis),
• can be on any type of medication.

• previous participation in Athlete's Heart Study
• has completed resting cardiac magnetic resonance imaging and resting electrocardiogram

Exclusion Criteria

• females
• no more than >1 hour per week of resistance training
• treatment or prior diagnosis of cardiovascular disease, valvular disease, hypertension, heart failure, diabetes, thyroid disorder, sleep apnea, current/recent viral disease, chronic inflammatory disease
• previous (within 10 years) or current smoking
• recreational drug use or alcohol consumption in excess of accepted standards
• inability to provide informed consent
• inability to verify AF diagnosis (if AF athlete).

• Minimum Eligible Age: 45 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: MALE
• Accepts Healthy Volunteers: Yes

Sponsors

Unity Health Toronto

OTHER

Sponsor Role: collaborator

University of Toronto

OTHER

Sponsor Role: lead

Responsible Party

Emily Vecchiarelli

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Emily Vecchiarelli, BKin

Role: PRINCIPAL_INVESTIGATOR

University of Toronto

Jack Goodman, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Toronto

Paul Dorian, MD

Role: PRINCIPAL_INVESTIGATOR

Unity Health Toronto

Locations

Goldring Center for High Performance

Toronto, Ontario, Canada

Countries

Canada

References

Molina L, Mont L, Marrugat J, Berruezo A, Brugada J, Bruguera J, Rebato C, Elosua R. Long-term endurance sport practice increases the incidence of lone atrial fibrillation in men: a follow-up study. Europace. 2008 May;10(5):618-23. doi: 10.1093/europace/eun071. Epub 2008 Apr 4.

Reference Type: BACKGROUND

PMID: 18390875 (View on PubMed)

Grimsmo J, Grundvold I, Maehlum S, Arnesen H. High prevalence of atrial fibrillation in long-term endurance cross-country skiers: echocardiographic findings and possible predictors--a 28-30 years follow-up study. Eur J Cardiovasc Prev Rehabil. 2010 Feb;17(1):100-5. doi: 10.1097/HJR.0b013e32833226be.

Reference Type: BACKGROUND

PMID: 20065854 (View on PubMed)

Calvo N, Brugada J, Sitges M, Mont L. Atrial fibrillation and atrial flutter in athletes. Br J Sports Med. 2012 Nov;46 Suppl 1:i37-43. doi: 10.1136/bjsports-2012-091171.

Reference Type: BACKGROUND

PMID: 23097477 (View on PubMed)

Provided Documents

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

AthletesHeartUofT

Identifier Type: -

Identifier Source: org_study_id