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Arrhythmias in long-distance cross-country skiers

Comment by Erik Ekker Solberg, EACPR Sports Cardiology Section

Risk of arrhythmias in 52 755 long-distance cross-country skiers: a cohort study
Kasper Andersen, Bahman Farahmand, Anders Ahlbom, et al.
European Heart Journal, first published online 11 June 2013; DOI: 10.1093/eurheartj/eht188


This Swedish study explores the association between finishing time, number of completed races and frequency and type of arrhythmias in more than 52000 participants in 'Vasaloppet', a 90 km cross-country ski race in Sweden.

During the 10 years observation period, hospitalisation for any arrhythmia and diagnoses of atrial fibrillation/flutter (AF), bradyarrhythmias, other supraventricular tachycardias (SVT) and ventricular tachycardia/ventricular fibrillation/cardiac arrest (VT/VF/CA) were registered.

In this uncontrolled study, 919 participants (about 2 %) experienced arrhythmias during the study period. Those finishing the highest number of races and those who had the fastest relative finishing time had higher risk of any arrhythmias.

These findings were mainly driven by a higher incidence of AF and bradyarrhythmias. No association with SVT or VT/VF/CA was found.

In a cohort design, and not only controlled design as many other studies on AF in endurance athletes, this study supports that athletes with a high load of endurance training develop higher risk of AF.

The continued emphasis on comprehensive health registers in Sweden facilitates the conduct of such quality studies.