Mechanistic Insights Into Reduced Arrhythmia Prevalence in Female Endurance Athletes

P D'Ambrosio; J De Paepe; SJ Rowe; K Janssens; AM Mitchell; T Van Puyvelde; LW Spencer; J Bogaert; O Ghekiere; R Pauwels; L Herbots; T Robyns; PM Kistler; JM Kalman; H Heidbuchel; R Willems; G Claessen; A La Gerche; Y Bekhuis; P Hespel; S Dymarkowski; T Dresselaers; H Miljoen; K Favere; B Paelinck; D Vermeulen; I Witvrouwen; D Hansen; BOT Eijnde; D Thijs; P Vanvoorden; K Lefebvre; E Paratz; MJ Brosnan; DL Prior

Journal article

Mechanistic Insights Into Reduced Arrhythmia Prevalence in Female Endurance Athletes

P D'Ambrosio, J De Paepe, SJ Rowe, K Janssens, AM Mitchell, T Van Puyvelde, LW Spencer, J Bogaert, O Ghekiere, R Pauwels, L Herbots, T Robyns, PM Kistler, JM Kalman, H Heidbuchel, R Willems, G Claessen, A La Gerche, Y Bekhuis, P Hespel Show all

JACC: Clinical Electrophysiology | Elsevier | Published : 2025

DOI: 10.1016/j.jacep.2025.05.023

Abstract

Background: Female athletes exhibit lower rates of atrial fibrillation (AF) and sudden cardiac death compared with male athletes, but the mechanisms behind this sex disparity in arrhythmia risk remain unclear. Methods: This study analyzed findings from Holter monitors, echocardiograms, and cardiac magnetic resonance imaging in a cohort of 397 endurance athletes enriched with prevalent AF. Athletes with cardiomyopathies, channelopathies, pre-excitation, and/or myocardial infarction were excluded. Results: Female athletes (n = 125; age 27 [18-47] years) had a lower prevalence of AF (6% vs 31%; P < 0.001) and nonsustained ventricular tachycardia (2% vs 11%; P = 0.004) than male athletes (n = 27..

View full abstract