Atrial Fibrillation and the Endurance Athlete

As a 58 year old competitive cyclist, Dr. Alan Bragman was out for a training ride when he didn’t feel well, so decided to call it a day and pedal easy on home. Then came the shortness of breath and chest pains that got him off of the bike and eventually into the hospital.

The diagnosis for this fit and healthy individual?

Atrial Fibrillation.

(For the full and very interesting account, please see Dr. Bragman’s blog post.)

Atrial Fibrillation, or AF (since we are a culture that loves acronyms), refers to a malfunction of the two upper chambers of the heart.

The heart is a muscle with four hollow chambers that through some complex coordinated actions, pumps blood throughout our body for a lifetime.

What happens in fibrillation is an uncoordinated contraction and the blood is not pumped through efficiently. (Think of someone who is trying to dance but is hopelessly out of synch with the music – like the video below.)

Here’s a more serious and educational depiction:

So when blood is not pumped through the heart, it tends to pool. Inactive blood leads to clotting, which can create some severe problems when blood clots go visiting different organs in the body.

AF and Endurance Athletes
The medical literature continues to collect solid data on the increase in AF in endurance athletes and there is quite a bit of it.

Luckily for most of us, the problems seem to appear when looking at the intensity of the exercise.

So don’t despair of having to give up your workouts. What the Science is showing us is that the hardcore, high intensity type of endurance exercise is what gives us problems later in life. We sort of wear out the atria of the heart and they come to function less efficiently.

This all seems to go against what we have learned and espoused over the years but remember that there are a lot of us who have spent a lifetime participating in endurance events, so the scientists finally have a large population to study. Before us Boomers, lifelong endurance athletes were not as plentiful.

What To Do About AF?
First off, just because you are an older athlete, doesn’t mean that you will experience AF in your lifetime. As with so much in endurance sports, the tremendous number of variables (genetics, training, diet, environment, etc.) make something like AF another one of those possibilities that may or may not present.

The most logical concept is to limit your really high intensity workouts. (Let’s be real – the number of us preparing for Ironman is probably very small.) Focus on staying aerobic during your workouts. Running seems to present some cardiac challenges but cycling and walking do well for providing the exercise we need without creating heart risks.

If you have a history of cardiac issues, stay in communication with your physicians. Make sure you let them know what you are planning to do or change in your workouts. They can advise, as well as adjust medication levels to make working out a safer and more enjoyable experience.

AF notwithstanding, endurance exercise is still a Life enhancing activity that provides benefits to the athlete over a lifetime. As with so many things in Life, we are just finding out that exercise is also one of these things we need to enjoy in moderation.