Study: Athletes Are More Likely to Develop Irregular Heartbeat Than Non-Athletes

Young athletes running.

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Key Takeaways

  • New research finds that athletes are more prone to atrial fibrillation than non-athletes.
  • Mixed sports such as rugby led to a higher risk than endurance sports like running.
  • Even though percentages are higher in athletes, actual occurrences are still low.

Although many assume that those that do cardiovascular exercise regularly are less likely to develop heart issues, recent research found that athletes may have more than twice the risk of atrial fibrillation—or an irregular heart rhythm.

The study was a survey and analysis of 13 studies published over the course of 30 years from 1990 to 2020, encompassing more than 70,478 participants. Of those, 6,816 were considered athletes.

What Is Atrial Fibrillation?

Atrial fibrillation, sometimes abbreviated as Afib, is a fast and irregular heart rhythm caused by extremely rapid and chaotic electrical impulses originating in the heart's atria. It can present in various ways, including feeling unwell with no distinct cause, shortness of breath with exertion, or awareness that the heart is beating at an irregular rate.

Surprisingly, researchers found that the risk of atrial fibrillation was more than double for athletes, or 2.46 times higher than for non-athletes. Younger athletes were 3.6 times more likely to experience atrial fibrillation than those over 55. The July study was published in the British Journal of Sports Medicine.

It seems that the type of sport also played a part. The study contradicted a long-held belief that endurance sports such as running or skiing held greater cardiovascular risk than other mixed sports such as rugby or football. In fact, the occurrence of afib was higher for mixed sports athletes.

The study also accounted for other cardiovascular risk factors such as type 2 diabetes or high blood pressure. When looking at athletes and non-athletes that all had these other risk factors, there was little difference in their occurrence of afib.

The Risk May Not Be as High as It Seems

Chirag Barbhaiya, MD, cardiac electrophysiologist and director of clinical research for Cardiac Electrophysiology at NYU Langone Health, tells Verywell that while the numbers seem high, atrial fibrillation in young people is still considered fairly rare.

"There's a difference between relative risk and absolute risk," Barbhaiya says. "Even though the risk goes up by a significant multiple, the overall numbers are quite small."

Additionally, Barbhaiya says, athletes are typically more attuned to their performance and physical sensations, making them more sensitive to the symptoms of atrial fibrillation and more likely to seek treatment.

And as for differences across sports, Barbhaiya says that the intensity of exertion may account for the increased likelihood of atrial fibrillation for those who partake in mixed sports compared to endurance sports.

"The duration of the strain to the heart muscle is less important than the intensity of the strain," Barbhaiya says.

For example, he says rowers and weightlifters come to mind, which put in intense effort for a short amount of time. These athletes have demonstrated tendencies for afib as well. He also notes that some mixed sports have cultural behaviors that increase atrial fibrillation, especially alcohol consumption.

"There's a whole culture around rugby that involves significant drinking, and it's one of the best-established lifestyle risk factors associated with afib," he says.

What This Means For You

If you're an athlete who has experienced atrial fibrillation symptoms, get checked out by your primary care physician. Still, doctors say there are greater benefits to regular exercise than risks.

There Is Some Good News

Overall, Barbhaiya stresses that are there are also several important positive takeaways from these findings.

"One of the most potentially reassuring findings was that if you have other risk factors, exercise didn't seem to be an additional risk factor for you," Barbhaiya says. "This suggests that if you have cardiovascular risk factors, then exercising actually isn't a risk. It will often counteract the increased cardiovascular risk factors."

Since the risk of atrial fibrillation actually went down with age, Barbhaiya says that this data should encourage heart patients to continue exercising and building the heart muscle as prescribed by their physician.

1 Source
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  1. Newman W, Parry-Williams G, Wiles J, et al. British Journal of Sports Medicine  Risk of atrial fibrillation in athletes: a systematic review and meta-analysis. 2021. doi:10.1136/bjsports-2021-103994.

By Rachel Murphy
Rachel Murphy is a Kansas City, MO, journalist with more than 10 years of experience.