📌 TL;DR: Caso de maratonista con AF después de entrenamiento intenso, tratado y recuperado exitosamente.
🔬 Puntos clave:
- Atrial fibrillation más común en atletas intensivos.
- AF asociada a remodelación atrial, desequilibrio autonómico e inflamación.
- Régimen control de ritmo, especialmente ablaquía por cateter, mejora el rendimiento y calidad de vida.
- Alto volumen de entrenamiento persiste como riesgo residual.
🎯 Aplicación clínica para LATAM:
En Panamá y América Latina, este estudio sugiere que los atletas con un alto nivel de entrenamiento deben ser vigilados por ritmo cardíaco. La ablaquía por cateter puede ser una opción segura y efectiva para prevenir la AF en estos casos.
⚠ Limitaciones:
El estudio se basa en caso único, limitando su generalizabilidad a poblaciones más amplias de atletas con AF.
Background
High-volume endurance training may shift exercise from cardioprotective to arrhythmogenic, increasing the risk of atrial fibrillation (AF) in healthy athletes.
Case summary
A 38-year-old marathon runner with a 15-year history of high-intensity endurance training presented with episodic palpitations and reduced athletic performance. Electrocardiogram showed paroxysmal AF; echocardiography revealed mild left atrial enlargement without structural heart disease. Symptoms worsened during the recovery phase after runs, suggesting vagally mediated AF. After unsuccessful flecainide therapy, he underwent pulmonary vein isolation. Twelve months later, he remained free of recurrent AF on Holter monitoring and successfully resumed endurance training following an 8-week recovery period. However, ongoing high-volume exercise may still carry a residual risk of arrhythmia.
Review summary
AF in athletes is associated with a 2- to 5-fold increased prevalence linked to atrial remodeling, autonomic imbalance, and inflammation. Rhythm control, especially catheter ablation, preserves performance and quality of life.
Take-home message
Excessive endurance training increases AF risk; early rhythm control and structured return-to-play strategies optimize outcomes.
Cómo citar:
Alameh I, Al Fout G, Ezekowitz MD, Kamareddine M. (2026).
Atrial Fibrillation in Athletes: Mechanisms, Management, and Future Directions.. JACC. Case reports.
DOI: 10.1016/j.jaccas.2026.107061 ↗ PMID: 41906559 ↗ Acceso al paper: Ver completo ↗
