RESUMEN
BACKGROUND: Atrial arrhythmias occur at a higher than expected prevalence amongst endurance athletes. Few studies have examined both atrial structure and arrhythmias in middle-aged endurance athletes. We examined the relationship between P-wave duration, atrial dimensions, and the presence of atrial ectopy in long-standing, middle-aged endurance athletes. METHODS: Middle-aged athletes with a minimum of 10â¯years of competitive endurance sport history and no history of structural heart disease or clinical atrial arrhythmias, had 12-lead ECGs to assess P-wave duration, signal-averaged ECGs (SAECG) to assess filtered P-wave duration, a 24â¯h Holter monitor to assess atrial ectopy, and echocardiography and cardiac magnetic resonance imaging to assess atrial structural characteristics. RESULTS: Amongst endurance athletes (nâ¯=â¯104; mean ageâ¯=â¯54⯱â¯5â¯years; 63% male), filtered P-wave duration on SAECG was correlated with P-wave duration on 12-lead ECG (râ¯=â¯0.36, p, 0.0001), as well as with larger CMR-derived RA areas (râ¯=â¯0.30, pâ¯=â¯0.01) and volumes (râ¯=â¯0.24, pâ¯<â¯0.05). There was no correlation between filtered P-wave duration and any LA measures on imaging (pâ¯>â¯0.05). There was no correlation between the incidence of atrial ectopy (premature atrial contractions or atrial tachycardia) and any electrocardiographic or structural measures. CONCLUSION: Longer filtered P-wave duration was associated with larger RA areas and volumes, without an increase in atrial ectopy.