Determining the best approach to reduce the impact of exercise-induced atrial fibrillation: prevention, screening, or symptom-based treatment?

Introduction: Regular endurance exercise over the course of many years appears to increase the risk of atrial fibrillation (AF). These data challenge the notion that the benefits of physical activity have no appreciable limits. The incidence of exercise-induced AF is expected to increase as a consequence of the popularity of extreme endurance sports. Actions to reduce its impact are warranted. Areas covered: This review focuses on exercise-induced AF and reviews the existing data regarding the prevention, screening, and treatment of this disease, with the aim of elucidating the best options for this group of patients. Expert commentary: To date, strategies to deal with exercise-induced AF are unsatisfactory. Improved knowledge of AF pathology and better classification schemes are needed to address current pitfalls.