Atrial Fibrillation in 63-Year-Old Former Elite Endurance Athletes: A 38-Year Follow-Up Study

We think our study does not support doing ambulatory ECG recording of all ExA at age 65, but one should be aware of increased risk in males with a paternal history of AF. Both AF and symptomatic tachycardias were significantly increased in males. However, the low number of AF is a limitation of these conclusions and does not permit concluding on whether training during middle age confers a higher risk of AF than training at a younger age. No sex differences in training in ExA indicate that biological factors (like hormones) contribute considerably to the sex difference in the risk of AF in ExA. Despite the low number of AF cases, we believe our study provides new knowledge as it is prospective, free of baseline selection bias, includes detailed investigations both at baseline and at follow-up, and addresses a gap in prospective studies on AF in EA.