The aim of this study was to examine by a systematic literature review and meta-analysis whether the risk of atrial fibrillation (AF) is higher in athletes compared with not athletes.

A comprehensive systematic search was conducted for case–control studies that examined cases of AF or atrial flutter in athletes vs. controls. Extracted data from the eligible studies were meta-analysed using fixed effects model. Six case–control studies were eligible for meta-analysis. A total of 655 athletes and 895 controls were compared. Mean age was 51 ± 9 years and 93% were men. There were 147 (23%) vs. 116 (12.5%) cases of AF among athletes compared with controls. The overall risk of AF was significantly higher in athletes than in controls with odds ratio (95% confidence interval) = 5.29 (3.57–7.85), P = 0.0001, and Z-score = 8.08. For heterogeneity, the calculated χ² = 2.92, P = 0.633, and I² = 0% were not significant.

The risk of AF is significantly higher in athletes compared with not athletes. However, this finding should be confirmed further in large-scale prospective longitudinal studies.