Understanding the Increased Risk of Atrial Fibrillation in Athletes: a Case-control Study

NCT06844656 | Not Yet Recruiting

• 1 other identifier: 1001
• Study Type: observational
• Target: 200
• Locations: 1 country
• Sites: 1

Brief Summary

Exercise is beneficial to heart health, however, there appears to be a 'U' shaped relationship where too much exercise may increase the risk of an irregular heart rhythm, called atrial fibrillation. Endurance athletes may have up to a 2.5-fold higher risk of developing atrial fibrillation than non-athletic controls. The mechanisms behind this increased risk of atrial fibrillation are not the well understood. It is thought to be a mixture of enlarged heart chambers, low resting heart rate, genetic predisposition and possibly scarring in the heart. In this study, the investigators will investigate the electrical activity changes in the heart, using a high-quality electrocardiogram (ECG) and relate this to changes in the heart size measured by ultrasound and MRI. Cardiopulmonary exercise testing will determine fitness (V̇O2 max) and assess the heart's electrical activity during exercise. This will be a case-control study where athletes with and without atrial fibrillation will be recruited. The investigators hope the results of this study can improve our understanding of atrial fibrillation in athletes by associating atrial fibrillation with structural and electrical differences which may aid the prediction of future atrial fibrillation development and help guide more athlete-specific treatment pathways.

Conditions

Atrial Fibrillation (AF)

Keywords

Atrial Fibrillation; Athletes; Sport; Physical Activity; Exercise; Arrhythmias

Outcome Measures

Primary Outcomes (1)

• High-resolution ECG

  Using high quality ECG, assess whether subtle differences can be detected in athletes with AF, compared to athletes without AF, and whether machine learning could predict new-onset AF. Detection of subtle differences in p wave parameters (duration, amplitude, dispersion, PTFV1) in athletes with AF compared to athletes without AF. AUC, specificity and sensitivity.

  At study visit

Secondary Outcomes (19)

• AI classification and prediction

  At study visit

• 72hr heart rate monitoring

  At study visit

• Electronic stethoscope recording

  At study visit

• Cardiac imaging

  At study visit

• Cardiac imaging

  At study visit

Study Arms (2)

AF Athletes

Athletes with atrial fibrillation.

Non-AF Athletes

Athletes without atrial fibrillation.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Endurance athletes with and without atrial fibrillation from across the United Kingdom. Recruitment through social media, sports clubs, and word of mouth.

You may qualify if:

• ≥18 years of age at the time of enrolment, male and female.
• History of atrial fibrillation confirmed on ECG - either paroxysmal or persistent.
• Competitive athlete. Defined as:
• Competed in endurance sports with a total cumulative moderate to high intensity of \> 1500 hours.
• Have participated in at least one competitive event in the last 10 years.

You may not qualify if:

• Permanent atrial fibrillation.
• History of pre-existing cardiovascular disease :
• Atherosclerotic disease: previous myocardial infarction, symptomatic coronary artery disease or Peripheral peripheral arterial disease
• Left ventricular systolic dysfunction (EF \< 45%)
• Heart muscle disease: cardiomyopathies, Infiltrative diseases of the heart
• Complex Congenital heart disease
• Moderate or severe valvular disease
• Uncontrolled hypertension (\>180/100mmHg)

Sponsors & Collaborators

• University of Leicester: lead

Study Sites (1)

Department of Cardiovascular Sciences. University of Leicester. Glenfield Hospital.

Leicester, LE3 9QP, United Kingdom

Location

Biospecimen

Retention: SAMPLES WITH DNA

Plasma, serum, buffycoat

MeSH Terms

Conditions

Atrial Fibrillation; Motor Activity; Arrhythmias, Cardiac

Condition Hierarchy (Ancestors)

Heart Diseases; Cardiovascular Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Behavior

Central Study Contacts

Cai L Davies

CONTACT

+447765791818; cld43@leicester.ac.uk

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 27, 2025
• First Posted: February 25, 2025
• Study Start: February 28, 2025
• Primary Completion (Estimated): October 10, 2026
• Study Completion (Estimated): October 10, 2026
• Last Updated: February 25, 2025

Record last verified: 2025-02

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)