{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:07:17Z","timestamp":1790644037329,"version":"4.1.0"},"reference-count":80,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T00:00:00Z","timestamp":1734393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The confirmed benefits of regular moderate exercise on cardiovascular health have positioned athletes as an illustration of well-being. However, concerns have arisen regarding the potential predisposition to arrhythmias in individuals engaged in prolonged strenuous exercise. Atrial fibrillation (AF), the most common heart arrhythmia, is typically associated with age-related risks but has been documented in otherwise healthy young and middle-aged endurance athletes. The mechanism responsible for AF involves atrial remodeling, fibrosis, inflammation, and alterations in autonomic tone, all of which intersect with the demands of endurance sports, cumulative training hours, and competitive participation. This unique lifestyle requires a tailored therapeutic approach, often favoring radiofrequency ablation as the preferred treatment. As the number of professional and non-professional athletes engaging in high-level daily sports activities rises, awareness of AF within this demographic becomes imperative. This review delivers the etiology, pathophysiology, and therapeutic considerations surrounding AF in endurance sports.<\/jats:p>","DOI":"10.3390\/jcm13247691","type":"journal-article","created":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T05:26:02Z","timestamp":1734413162000},"page":"7691","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Endurance Sports and Atrial Fibrillation: A Puzzling Conundrum"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2448-1799","authenticated-orcid":false,"given":"Marina","family":"Ostojic","sequence":"first","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"},{"name":"School of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mladen","family":"Ostojic","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6631-6353","authenticated-orcid":false,"given":"Olga","family":"Petrovic","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"},{"name":"School of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Nedeljkovic-Arsenovic","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Radiology and MRI Department, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1418-7908","authenticated-orcid":false,"given":"Francesco","family":"Perone","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Unit, Rehabilitation Clinic \u201cVilla delleMagnolie\u201d, 81020 Castel Morrone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Banovic","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"},{"name":"School of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Stojmenovic","sequence":"additional","affiliation":[{"name":"Faculty of Physical Culture and Sports Management, Singidunum University, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5772-5692","authenticated-orcid":false,"given":"Dragutin","family":"Stojmenovic","sequence":"additional","affiliation":[{"name":"Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1049-6321","authenticated-orcid":false,"given":"Vojislav","family":"Giga","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"},{"name":"School of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9452-8241","authenticated-orcid":false,"given":"Branko","family":"Beleslin","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"},{"name":"School of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5552-773X","authenticated-orcid":false,"given":"Ivana","family":"Nedeljkovic","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"},{"name":"School of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur. 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