Using Atrial Cardiomyopathy Metrics to Characterize Atrial Fibrillation in Endurance Athletes

Spencer, LW; D' Ambrosio, P; Ohanian, M; Janssens, K; Mitchell, AM; Rowe, SJ; Flannery, MD; Young, PE; Soka, M; Johnson, R; Yu, C; Morris, GM; Lacaze, P; Giannoulatou, E; Van Puyvelde, T; Bekhuis, Y; Ray, M; Pauwels, R; De Paepe, J; Robyns, T; Delpire, B; Prior, DL; Kistler, PM; Kalman, JM; Sanders, P; Elliott, AD; Willems, R; Heidbuchel, H; Claessen, G; Fatkin, D; Gerche, A; Pro@Heart Consortium

doi:10.1016/j.jacep.2026.03.010

Using Atrial Cardiomyopathy Metrics to Characterize Atrial Fibrillation in Endurance Athletes

JACC Clin ElectrophysiolPublished 23 Apr 2026Development of an atrial fibrillation (AF) probability model by logistic regression in endurance athletes and nonathletic control subjects

Performance · LA volumeResultRelative difference 40% larger

Read the original article ↗PubMed

Cite

Authors' conclusion

A combination of atrial cardiomyopathy markers was associated with high AF prevalence in EAs. A resulting quantitative AF risk identification tool provides promise for interventions aimed at preventing AF and thromboembolic complications in EAs.

Study context

Population: Endurance athletes (EAs) and nonathletic control subjects (NAs)EAs 353 · NAs 97

Comparison: Associations between AF and electrophysiologic, imaging, and genetic markers of atrial cardiomyopathy in EAs
EAsn = 353
NAsn = 97
EAs with AFn = 96
Outcome: LA volume

Methodological detailscomprehensive phenotyping, polygenic risk scores for AF (AF-PRS)

Comprehensive phenotyping
Polygenic risk scores for AF (AF-PRS)

Performance

As reported in the abstract

Relative difference

40% larger

P < 0.001

By group

EAs42.9mL/m²

NAs29.7mL/m²

Further findings

Outcome	EAs with AF	EAs without AF
LA volume among EAs	46.2 mL/m²	41.9 mL/m²
LA strain (reservoir) among EAs	26%	32%
P-wave duration among EAs	124 ms	111 ms
Abnormal P-wave terminal force velocity in lead V1 among EAs	26%	9%
PACs among EAs	118 PACs/24 h	15 PACs/24 h

LA volume among EAs: P < 0.001
LA strain (reservoir) among EAs: P < 0.001
P-wave duration among EAs: P < 0.001
Abnormal P-wave terminal force velocity in lead V1 among EAs: P < 0.001
Premature atrial contractions (PACs) among EAs: P < 0.001

Prevalent AF among EAs

EAs with prevalent AF (of the EAs): 96 (27%)

Discrimination of clinical risk model for AF

AUC: 0.84

AF odds with high AF-PRS

High AF-PRS increased AF odds: 2.56-fold
Contributed little additional predictive value

AF prevalence by model risk category

Low risk athletes: 4%
Very high risk athletes: 86%

Reference

Authors: Spencer LW, D' Ambrosio P, Ohanian M, Janssens K, Mitchell AM, Rowe SJ, et al.
All 32 authors
Spencer LW, D' Ambrosio P, Ohanian M, Janssens K, Mitchell AM, Rowe SJ, Flannery MD, Young PE, Soka M, Johnson R, Yu C, Morris GM, Lacaze P, Giannoulatou E, Van Puyvelde T, Bekhuis Y, Ray M, Pauwels R, De Paepe J, Robyns T, Delpire B, Prior DL, Kistler PM, Kalman JM, Sanders P, Elliott AD, Willems R, Heidbuchel H, Claessen G, Fatkin D, Gerche A, Pro@Heart Consortium
Journal: JACC: Clinical Electrophysiology
Published: 23 Apr 2026
DOI: 10.1016/j.jacep.2026.03.010
PubMed: 42029375

Topic: Arrhythmias & electrophysiology
Also indexed: Cardiovascular imaging

Diagnostic definitions

EAs: endurance athletes; median age 41 years, 74% male
NAs: nonathletic control subjects; median age 34 years, 64% male
EAs with AF: EAs with prevalent AF

Original publication

Using Atrial Cardiomyopathy Metrics to Characterize Atrial Fibrillation in Endurance Athletes. JACC Clin Electrophysiol. Published 23 April 2026. doi:10.1016/j.jacep.2026.03.010

Read the original article ↗

Composed by AI from the published abstract and checked against it. How Briefs are made →