Slow Recovery of the Right and Left Ventricular Deformation after Conversion from Atrial Fibrillation
American Journal of Sports Science
Volume 2, Issue 2, March 2014, Pages: 13-16
Received: Jan. 2, 2014;
Published: Feb. 20, 2014
Views 3001 Downloads 117
Roman Leischik, Dept. Prevention and Sports Medicine, University Witten-Herdecke, Chair Cardiology, Prof. M. Seyfarth, Hagen, Germany
Henning Littwitz, Dept. Prevention and Sports Medicine, University Witten-Herdecke, Chair Cardiology, Prof. M. Seyfarth, Hagen, Germany
Atrial fibrillation (AF) is a possible complication of sport in middle-aged athletes. When sinus rhythm has been restored, at what time is deformation restored too? This question has never been answered. We studied an one 47-year old cyclist and runner with acute lone atrial fibrillation. A day before, he trained hard intervals and felt at the next day an irregular rhythm, training was not possible. He told this would occure 2 times a year , but after the light training the irregular puls will disappear. At the chest-pain unit we performed echocardiography inclusive strain measurements of the right and left ventricle during atrial fibrillation and immediately after the recovery of the sinus rhythm. He recovered to sinus rhythm during the exercise test. Global strain was at the moment of atrial fibrillation – 11.8%, direct after the recovery of the sinus rhythm -17,2%, and -20.5% at the next day, even though the normalized diastolic function directly after conversion from AF. It seems to be that the heterogenity of the deformation need time to recovery after the conversion to the sinus rhythm, even though the diastolic function seems to be normalized. The further endurance training should be continued only after normalization of deformation values.
Slow Recovery of the Right and Left Ventricular Deformation after Conversion from Atrial Fibrillation, American Journal of Sports Science.
Vol. 2, No. 2,
2014, pp. 13-16.
Zehender, M., T. Meinertz, J. Keul and H. Just (1990) ECG variants and cardiac arrhythmias in athletes: clinical relevance and prognostic importance. Am Heart J. 119, 1378-1391.
Calvo, N., J. Brugada, M. Sitges and L. Mont (2012) Atrial fibrillation and atrial flutter in athletes. Br J Sports Med. 46 Suppl 1, i37-43.
Pelliccia, A., B.J. Maron, F.M. Di Paolo, A. Biffi, F.M. Quattrini, C. Pisicchio, A. Roselli, S. Caselli and F. Culasso (2005) Prevalence and clinical significance of left atrial remodeling in competitive athletes. J Am Coll Cardiol. 46, 690-696.
Voigt, J.-U., B. Exner, K. Schmiedehausen, C. Huchzermeyer, U. Reulbach, U. Nixdorff, G. Platsch, T. Kuwert, W.G. Daniel and F.A. Flachskampf (2003) Strain-rate imaging during dobutamine stress echocardiography provides objective evidence of inducible ischemia. Circulation. 107, 2120-2126.
Heimdal, A., A. Støylen, H. Torp and T. Skjærpe (1998) Real-time strain rate imaging of the left ventricle by ultrasound. Journal of the American Society of Echocardiography. 11, 1013-1019.
Feigenbaum, H., R. Mastouri and S. Sawada (2012) A practical approach to using strain echocardiography to evaluate the left ventricle. Circ J. 76, 1550-1555.
Simsek, Z., M.H. Tas, E. Gunay and H. Degirmenci (2013) Speckle-tracking echocardiographic imaging of the right ventricular systolic and diastolic parameters in chronic exercise. Int J Cardiovasc Imaging. 29, 1265-1271.
Lang, R.M., M. Bierig, R.B. Devereux, F.A. Flachskampf, E. Foster, P.A. Pellikka, M.H. Picard, M.J. Roman, J. Seward and J. Shanewise (2006) Recommendations for chamber quantification. European Journal of Echocardiography. 7, 79-108.
La Gerche, A., A.T. Burns, D.J. Mooney, W.J. Inder, A.J. Taylor, J. Bogaert, A.I. MacIsaac, H. Heidbüchel and D.L. Prior (2012) Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes. European heart journal. 33, 998-1006.
Oxborough, D., K. Birch, R. Shave and K. George (2010) "Exercise-induced cardiac fatigue"--a review of the echocardiographic literature. Echocardiography. 27, 1130-1140.
Calvo, N., L. Mont, D. Tamborero, A. Berruezo, G. Viola, E. Guasch, M. Nadal, D. Andreu, B. Vidal and M. Sitges (2010) Efficacy of circumferential pulmonary vein ablation of atrial fibrillation in endurance athletes. Europace. 12, 30-36.
Lubitz, S.A., E.J. Benjamin, J.N. Ruskin, V. Fuster and P.T. Ellinor (2010) Challenges in the classification of atrial fibrillation. Nat Rev Cardiol. 7, 451-460.
Gallagher, M.M. and J. Camm (1998) Classification of atrial fibrillation. Am J Cardiol. 82, 18n-28n.
Burstein, B. and S. Nattel (2008) Atrial Fibrosis: Mechanisms and Clinical Relevance in Atrial Fibrillation. Journal of the American College of Cardiology. 51, 802-809.
Blair, S.N., H.W. Kohl, N.F. Gordon and R.S. Paffenbarger, Jr. (1992) How much physical activity is good for health? Annu Rev Public Health. 13, 99-126.
Lee, I.M. and P.J. Skerrett (2001) Physical activity and all-cause mortality: what is the dose-response relation? Med Sci Sports Exerc. 33, S459-471; discussion S493-454.
Eaton, S.B., L. Cordain and S. Lindeberg (2002) Evolutionary Health Promotion: A Consideration of Common Counterarguments. Preventive Medicine. 34, 119-123.
Bellavia, A., M. Bottai, A. Wolk and N. Orsini (2013) Physical activity and mortality in a prospective cohort of middle-aged and elderly men - a time perspective. Int J Behav Nutr Phys Act. 10, 94.
Andersen, K., B. Farahmand, A. Ahlbom, C. Held, S. Ljunghall, K. Michaelsson and J. Sundstrom (2013) Risk of arrhythmias in 52 755 long-distance cross-country skiers: a cohort study. Eur Heart J. .
Farahmand, B.Y., A. Ahlbom, O. Ekblom, B. Ekblom, U. Hallmarker, D. Aronson and G.P. Brobert (2003) Mortality amongst participants in Vasaloppet: a classical long-distance ski race in Sweden. J Intern Med. 253, 276-283.
Gajewski, A.K. and A. Poznanska (2008) Mortality of top athletes, actors and clergy in Poland: 1924-2000 follow-up study of the long term effect of physical activity. Eur J Epidemiol. 23, 335-340.
Marijon, E., M. Tafflet, J. Antero-Jacquemin, N. El Helou, G. Berthelot, D.S. Celermajer, W. Bougouin, N. Combes, O. Hermine and J.-P. Empana (2013) Mortality of French participants in the Tour de France (1947–2012). European heart journal. 34, 3145-3150.
Teramoto, M. and T.J. Bungum (2010) Mortality and longevity of elite athletes. J Sci Med Sport. 13, 410-416.
Sarna, S., T. Sahi, M. Koskenvuo and J. Kaprio (1993) Increased life expectancy of world class male athletes. Med Sci Sports Exerc. 25, 237-244.
Scharhag, J., H. Lollgen and W. Kindermann (2013) Competitive sports and the heart: benefit or risk? Dtsch Arztebl Int. 110, 14-23; quiz 24; e11-12.
O'Keefe, J.H., R.P. Harshal, C.J. Lavie, A. Magalski, R.A. Vogel and P.A. McCiiough (2012) Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise. Mayo Clin Proc. 87, 587-595.
Mohlenkamp, S., K. Leineweber, N. Lehmann, S. Braun, U. Roggenbuck, M. Perrey, M. Broecker-Preuss, T. Budde, M. Halle, K. Mann, K.H. Jockel, R. Erbel, and G. Heusch (2014) Coronary atherosclerosis burden, but not transient troponin elevation, predicts long-term outcome in recreational marathon runners. Basic Res Cardiol. 109, 391.
Whelton, S.P., A. Chin, X. Xin and J. He (2002) Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med. 136, 493-503.
Kaplan, N.M., R.B. Deveraux and H.S. Miller, Jr. (1994) 26th Bethesda conference: recommendations for determining eligibility for competition in athletes with cardiovascular abnormalities. Task Force 4: systemic hypertension. J Am Coll Cardiol. 24, 885-888.
Ehrlich, J.R., S.H. Hohnloser and S. Nattel (2006) Role of angiotensin system and effects of its inhibition in atrial fibrillation: clinical and experimental evidence. Eur Heart J. 27, 512-518.
Brilla, C.G., R.C. Funck and H. Rupp (2000) Lisinopril-mediated regression of myocardial fibrosis in patients with hypertensive heart disease. Circulation. 102, 1388-1393.