Arrhythmias & electrophysiologyCase-control study
Atrial fibrillation in former world-class rowers: role of environmental and genetic factors
- Matched case-control study
- matched 1:100 for age and sex
Authors' conclusion
Despite having a favourable cardiovascular risk factor profile compared with controls, elite endurance athletes had a markedly higher prevalence and incidence of AF.
Study context
- Population
- Former international-championship rowers aged 45–80 years vs age- and sex-matched UK Biobank controls
- Participants
- 121 vs 11,495
- Comparison
- Former world-class rowers vs UK Biobank controls
- Rowersn = 121
- Controlsn = 11,495reference
- Outcome
- AF prevalence (role of exercise burden vs genetic predisposition)
Main finding
AF prevalence
Prevalence risk ratio
6.8
95% CI 4.7–9.8
Events by group
Rowers vs Controls
prevalence risk ratio 6.8 (95% CI 4.7–9.8)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Rowers | Controls | HR (95% CI) | |
|---|---|---|---|---|
| Incident AF · 4-year follow-up · 6 of 95 rowers vs 252 of 11 131 controls | 6.3% | 2.3% | 2.8 (1.6–5.0) | |
| 0.20.5125Hazard ratio (log scale) |
Cardiac remodelling
- Athletes showed greater structural and electrophysiological cardiac remodelling than controls
CV risk factors and stroke
- Stroke prevalence, athletes vs controls
- 3.3% vs 1.1%
- Stroke risk ratio, athletes vs controls
- 3.0 (95% CI 1.1-7.9)
- Similar CV risk factor profiles in athletes and controls
Rare pathogenic/likely pathogenic cardiomyopathy gene variants
- Prevalence in athletes
- 2.7%
- Not enriched in athletes with atrial fibrillation (AF)
Odds of AF with high AF polygenic risk score (AF-PRS) (upper quartile of healthy reference population)
- Odds increase in athletes
- 3.7-fold (95% CI 1.5-9.4)
- Odds increase in controls
- 2.0-fold (95% CI 1.7-2.4)
- P = .37 for between-group comparisons
Original publication
Atrial fibrillation in former world-class rowers: role of environmental and genetic factors. Eur Heart J. Published 25 June 2025. doi:10.1093/eurheartj/ehaf369
Summarised from the published abstract; every number is checked against it