How much exercise is enough? Lard-azz couch potato or "super-fit" endurance athlete? Both may wind up as cardiac cripples as a result of their respective behavior. A decades long study of Scandinavian X-Country skiers first denoted a direct positive correlation between endurance racing and early onset atrial fibrillation. Not only was this prevalant, it was MOST prevalant in the MOST fit, and moreso the LONGER they raced. Here is more research from Medscape. To see the entire article, you'll likely have to register.
heheart.org on Medscape > Trials and Fibrillations with Dr John Mandrola Exercise, Overindulgence and Atrial Fibrillation: Seeing the Obvious
John Mandrola DisclosuresMay 21, 2014
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Editor's Note: This post originally appeared on drjohnm.org.
If you like thinking and writing, few topics are better than the excess exercise and heart disease story. Indeed it is a matter for the curious.
Two studies published last week in the British journal Heart addressed the relationship of exercise and heart disease[1,2]. Although these studies garnered mainstream media attention they added little to what is already known. Namely, that moderate exercise is protective and excessive exercise is detrimental. This has been dubbed the J-curve of exercise. You could also call it�obvious.
I've been to this place so many times, I was going to leave it alone this time.
Two things changed my mind.
One was a series of comments on my Is Atrial Fibrillation Necessary post on theheart.org . The post describes the fact that lifestyle factors, not bad luck, play a central role in atrial fibrillation and its treatment. I believe this research, from scientists in Adelaide Australia, is the most important work in all of electrophysiology.
The Australians are exposing our blind spot. Their findings force us to look at AF as a modifiable acquired disease. Modifiable not with drugs, or freezes, or burns, but with simple lifestyle choices. What we eat, how we sleep, how much weight we carry�these are the things that matter to the health of our atria. What makes the Australian work so compelling is that they connect basic science and physiology to real-world clinical outcomes.
It's important to note that the Adelaide brand of lifestyle intervention is aggressive. They enroll overweight patients in a physician-led clinic where multiple areas of health are addressed. These patients get results. Their weight drops, BP falls, sleep improves, blood sugar decreases, alcohol intake plummets. Through these anti-fibrillatory effects something else happens: they feel better. Go figure.
So, yes, the Australians are reversing AF in a population that is over-indulged.
Many of the readers here are endurance athletes. And when viewed from a distance, athletic people do not appear over-indulged, eg, they are not overweight. This sort of thinking came through in a number of the comments on my THO post.
"There are some skinny normal-BP people with AF and no valvular defect. Lifestyle modification will help many, but not all."
And this one:
"Strange thing is though, a remarkably high level of "super fit" people get Afib too�"
Can you see the intuitive (fast) thinking? That skinny and athletic equates to "healthy." Most doctors, those who don't roll with the athlete crowd, think this way.
I, and most of you, know better. Many, if not most, masters-aged athletes are completely and utterly, micro (last few weeks) and macro (last few decades) over-indulged. We've been at the train-like-Lance-ride-like-Lance game for a lifetime. Exercise is our drug. When we don't race fast, we train more, not less. A brisk 10K run isn't enough, we need to run a marathon, then two, and of course, many, like I once did, move to triathlon. Always more inflammation, not less.
