Arrhythmias & electrophysiology
Mechanistic Insights Into Reduced Arrhythmia Prevalence in Female Endurance Athletes
Authors' conclusion
Lower rates of AF and nonsustained ventricular tachycardia in female athletes may be attributed to smaller atrial and ventricular volumes and reduced cardiomyocyte hypertrophy, although there are likely additional modulating factors.
Study context
- Population
- Endurance athletes enriched with prevalent atrial fibrillation (AF); cardiomyopathies, channelopathies, pre-excitation and/or MI excluded
- Participants
- 397 athletes
- Comparison
- Female vs male endurance athletes
- Femalen = 125
- Malen = 272reference
- Outcome
- AF and nonsustained VT prevalence
Main finding
As reported in the abstract
AF
P < 0.001
Nonsustained VT
P = 0.004
Further findings
Age-adjusted LA volume
P = 0.007
Indexed LV end-diastolic volume
P < 0.001
Indexed RV end-diastolic volume
P < 0.001
Age-adjusted hinge and non-hinge-point fibrosis
- Hinge-point fibrosis 13% vs 24%, equally prevalent between the sexes
- P = 0.120
- Non-hinge-point fibrosis 12% vs 20%, equally prevalent between the sexes
- P = 0.875
Atrial and ventricular ectopy (vs 125 age-matched male athletes)
- Similar prevalence of atrial and ventricular ectopy
- Subset of 125 age-matched male athletes
Other measures in female athletes
- Lower maximal oxygen consumption despite comparable exercise volume and sports duration
- Lower LV mass, similar native T1 times, higher extracellular volume
- Less bradycardia and lower resting and peak exercise BP
Original publication
Mechanistic Insights Into Reduced Arrhythmia Prevalence in Female Endurance Athletes. JACC Clin Electrophysiol. Published 23 July 2025. doi:10.
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