Time Between Lone Paroxysmal Atrial Fibrillation Bouts And TrimpI: A Case Study

The diagnosis of atrial fibrillation (AF) in lifelong endurance athletes occurs at a greater incidence over a lifetime vs the general population. It is well established that this is related to lifetime training duration and intensity. PURPOSE: Therefore, the primary aim was to observe the cumulative effects of life-long endurance training (since the age of 10-yrs old) related to individualized training impulse (TRIMPi) and the occurrence of lone paroxysmal AF (PAF) in an otherwise healthy, 53-yr-old male with no diagnosed cardiovascular disease. METHODS: The complete health history of a 53-yr-old male (ht: 1.83 m, wt: 72.7 kg, VO2max: 56 ml/kg/min, HRmax: 185 bpm, no alcohol consumption the past 2 yrs, 7-day resting heart rate average/HRavg = 50 bpm) with diagnosed lone PAF (on January 21, 2016) was gathered and summarized from September 2018 to August 2023. Garmin Connect™ data were amassed and analyzed for physiological training metrics with an average value determined over a 35-day period prior to each documented PAF episode. A simple Pearson correction coefficient was performed on days between PAF episodes and each physiological metric, including TRIMPi, training distance (km), HRavg per workout (bpm), and total time of each workout (min). RESULTS: Eight PAF episodes occurred (i.e., Sept 2018 to Aug 2023). The 35-day average leading up to each lone PAF episode for select physiological metrics (e.g., during trail running, mountain biking) included (average ± SD): time per workout = 61.5 ± 22.7 min, HRavg per workout = 129.6 ± 4.2 bpm, TRIMPi = 85.9 ± 36.7, and total distance per day = 9.0 ± 2.9 km. A low negative correlation (- .37) was found between number of days leading up to a PAF episode vs TRIMPi. CONCLUSIONS: A PAF bout in this athlete seems to be slightly influenced by TRIMPi, such that greater duration and intensity of workouts over a 35-day period might lead to less days between (or more frequent) PAF episodes. This type of finding requires further analysis in a large cohort study.