Rowing Toward Risk? Elite Sport Linked to Atrial Fibrillation

Former elite rowers, despite their overall superior health and fitness, are more likely than the general population to develop atrial fibrillation (AFib), due to a complex relationship of intense endurance training and genetic predisposition.

A new peer-reviewed study, led by the Victor Chang Cardiac Research Institute and St Vincent’s Institute of Medical Research, has revealed a surprising health risk among some of the world’s fittest individuals—elite endurance athletes. The research, published in the European Heart Journal, focused on 121 former elite rowers from Australia, aged 45 to 80 years, including former Olympians, with approximately 25% being women. The unexpected discovery was that one in five of these athletes develops AFib.

The study’s most striking finding is that these retired rowers are nearly seven times more likely to develop AFib than members of the general population. This elevated risk is puzzling, given that these athletes possess fewer traditional AFib risk factors, such as high blood pressure, diabetes, and obesity. This highlights a critical paradox in which extreme fitness, typically associated with robust health, can, in specific contexts, contribute to certain cardiovascular vulnerabilities.

Professor André La Gerche, head of the Heart, Exercise and Research Trials (HEART) Laboratory, emphasized that the study definitively proves AFib can be a “side effect of endurance exercise.” He noted that many athletes were unaware of their condition until they were screened because AFib can develop without noticeable symptoms. The asymptomatic nature underscores the importance of proactive screening in this population.

A key development from this research is the identification of new genetic and clinical tools that can facilitate early preventive strategies. Professor Diane Fatkin, who conducted the genetic analysis, revealed that the likelihood of developing AFib was influenced not only by the effects of a lifetime of intense exercise training but also by each athlete’s unique genetic makeup. Furthermore, the study found that the risk of AFib persists and can even emerge well after athletes retire from elite sport, necessitating continued monitoring of their heart health for many years after retirement.

Although the study provides crucial insights, it also opens avenues for future research. Questions remain regarding how genetic variations specifically increase AFib risk, what factors trigger AFib episodes in athletes, and whether treatment protocols for AFib should differ for this highly specialized population compared with the general public.

Despite these findings, Professor La Gerche stressed the importance of maintaining perspective. He reiterated that athletes generally lead healthier, longer lives, and this research should not deter individuals from participating in endurance sports such as rowing. Instead, the study serves as a vital step forward in the field of heart injury prevention, aiming to make sports safer for everyone through enhanced understanding, early identification, and targeted interventions.