Abstract des Autors

A survey was carried out in endurance sportsmen with atrial fibrillation to gain insight into the characteristics and optimal treatment of this disease in this specific patient population. Patients were acquired with the help of several cardiologists. All patients were questioned by the same investigator. The group consisted of 44 well-trained endurance sportsmen with documented atrial fibrillation. Paroxysmal atrial fibrillation was the case in 41 persons, of whom four also had episodes of atrial flutter. In three patients it concerned chronic atrial fibrillation. The patients were involved in endurance sport for an average of 22 years, with a mean training expenditure of 8 hours a week during this period. In only 20% of the patients cardiologic examination by their own cardiologist revealed a possible cause for atrial fibrillation. The first symptoms started at a mean age of 41 years with a range from 19 to 59 years. Symptoms and progression of the disease varied remarkably among the different patients. In most of the patients it was possible to discern a vagal or adrenergic pattern in the attacks of atrial fibrillation. These patterns however showed no correlation with the treatment effects nor with the progression of the disease. In one third of the patients the attacks of atrial fibrillation increased when patients increased their sporting activities. However, 12% of the patients had less problems when they increased their sporting activities. Slightly more than half of the patients received treatment. Sotalol was used most frequently (25 of the 44 patients). The effect was disappointing since only 14 patients improved, 6 patients got worse and 5 did not improve. Flecainide acetate was used in most patients as second choice (15 of the 44 patients). The effect was better since 13 patients improved and only one got worse and one remained stable. Amiodarone was often used when all other medicines failed (9 of the 44 patients). The effect was reasonable with an improvement in 7 patients, while two remained stable. Verf.-Referat