{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T07:30:28Z","timestamp":1793172628814,"version":"4.5.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,8,6]]},"abstract":"\n Background<\/jats:title>\n \n Habitual high\u2010intensity endurance exercise is associated with increased atrial fibrillation (\n AF<\/jats:styled-content>\n ) risk and impaired cardiac conduction. It is unknown whether these observations extend to prior strength\u2010type sports exposure. The primary aim of this study was to compare\n AF<\/jats:styled-content>\n prevalence in former National Football League (\n NFL<\/jats:styled-content>\n ) athletes to population\u2010based controls. The secondary aim was to characterize other conduction system parameters.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n This cross\u2010sectional study compared former\n NFL<\/jats:styled-content>\n athletes (n=460, age 56\u00b112\u00a0years, black 47%) with population\u2010based controls of similar age and racial composition from the cardiovascular cohort Dallas Heart Study\u20102 (n=925, age 54\u00b19\u00a0years, black 53%).\n AF<\/jats:styled-content>\n was present in 28 individuals (n=23 [5%] in the\n NFL<\/jats:styled-content>\n group; n=5 [0.5%] in the control group). After controlling for other cardiovascular risk factors in multivariable regression analysis, former\n NFL<\/jats:styled-content>\n participation remained associated with a 5.7 (95%\n CI<\/jats:styled-content>\n : 2.1\u201315.9,\n P<\/jats:italic>\n <0.001) higher odds ratio of\n AF<\/jats:styled-content>\n . Older age, higher body mass index, and nonblack race were also independently associated with higher odds ratio of\n AF<\/jats:styled-content>\n , while hypertension and diabetes mellitus were not.\n AF<\/jats:styled-content>\n was previously undiagnosed in 15\/23 of the former\n NFL<\/jats:styled-content>\n players. Previously undiagnosed\n NFL<\/jats:styled-content>\n players were rate controlled and asymptomatic, but 80% had a\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n \u2010\n VAS<\/jats:styled-content>\n c score \u22651. Former\n NFL<\/jats:styled-content>\n players also had an 8\u2010fold higher prevalence of paced cardiac rhythms (2.0% versus 0.25%,\n P<\/jats:italic>\n <0.01), compared with controls. Furthermore, former athletes had lower resting heart rates (62\u00b111 versus 66\u00b111\u00a0beats per minute,\n P<\/jats:italic>\n <0.001), and a higher prevalence of first\u2010degree atrioventricular block (18% versus 9%,\n P<\/jats:italic>\n <0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Former\n NFL<\/jats:styled-content>\n participation was associated with an increased\n AF<\/jats:styled-content>\n prevalence and slowed cardiac conduction when compared with a population\u2010based control group. Former\n NFL<\/jats:styled-content>\n athletes who screened positive for\n AF<\/jats:styled-content>\n were generally rate controlled and asymptomatic, but 80% should have been considered for anticoagulation based on their stroke risk.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.118.010401","type":"journal-article","created":{"date-parts":[[2019,7,24]],"date-time":"2019-07-24T10:54:35Z","timestamp":1563965675000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Arrhythmias and Adaptations of the Cardiac Conduction System in Former National Football League Players"],"prefix":"10.1161","volume":"8","author":[{"given":"Philip","family":"Aagaard","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart and Vascular Institute Cleveland Clinic Foundation Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shishir","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Cardiology UT Southwestern Medical Center Dallas TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"McNamara","sequence":"additional","affiliation":[{"name":"Division of Cardiology UT Southwestern Medical Center Dallas TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parag","family":"Joshi","sequence":"additional","affiliation":[{"name":"Division of Cardiology UT Southwestern Medical Center Dallas TX"},{"name":"Johns Hopkins Ciccarone Center for the Prevention of Heart Disease Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colby R.","family":"Ayers","sequence":"additional","affiliation":[{"name":"Division of Cardiology UT Southwestern Medical Center Dallas TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"de Lemos","sequence":"additional","affiliation":[{"name":"Division of Cardiology UT Southwestern Medical Center Dallas TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew E.","family":"Lincoln","sequence":"additional","affiliation":[{"name":"MedStar Sports Medicine Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Baranowski","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart and Vascular Institute Cleveland Clinic Foundation Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Mandsager","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart and Vascular Institute Cleveland Clinic Foundation Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Hill","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Heart Institute Los Angeles 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