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Final Program


Program-At-A-Glance

Rapid Fire Session

Session: Rapid Fire Session 2: Arrhythmias (Monitor 11)

Cardiac re-modelling in athletic and normal populations as predictors of future AF; a pooled analysis of LOOP and VENTOUX

Thursday, February 5, 2026
3:59 PM - 4:06 PM  
Location: Galapagos / Aruba / Ilhabela (2nd Lower Level)

    Presenting Author(s)

  • Bradley Chambers

    Clinical Research Fellow
    University of Leeds
    Harewood, England, United Kingdom

    • Primary Author(s)

  • Bradley Chambers

    Clinical Research Fellow
    University of Leeds
    Harewood, England, United Kingdom

    • Co-Author(s)

  • LB

    Litten Bertelsen, PhD, MB

    Doctor
    Copenhagen University Hospital - Rigshospitalet, Denmark

  • Wasim Javed, MD, PhD, MSc

    Specialist Registrar
    University of Leeds
    Leeds, England, United Kingdom

  • TA

    Thomas Anderton, MBChB

    Clinical research fellow
    University of Leeds, Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, LS2 9JT, United Kingdom
    Leeds, England, United Kingdom

  • Maryum Farooq, MB

    Research Fellow
    Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds
    Leeds, England, United Kingdom

  • PH

    Peter L M Harrison, MD

    Dr
    LICAMM
    Leeds, England, United Kingdom

  • CS

    Ching-Hui Sia, MD

    Dr
    Leeds Institute of Cardiovascular and Metabolic Medicine, United Kingdom

  • Masafumi Takafuji, MD, PhD

    Clinical Research Fellow
    Leeds Institute of Cardiovascular and Metabolic Medicine
    Leeds, England, United Kingdom

  • MK

    Maria Kalaitzoglou, MD, MSc

    Clinical Research Fellow
    University of Leeds, United Kingdom

  • PT

    Panagiotis Tsiverdis

    Cardiology SpR
    University of Leeds, United Kingdom

  • CY

    Chin Yit Soo, MD

    Clinical Research Fellow
    University of Leeds
    Leeds, England, United Kingdom

  • MA

    Mehak Asad, MD, MPH

    Clinical research fellow
    University of Leeds, Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, LS2 9JT, United Kingdom
    Leeds, England, United Kingdom

  • ML

    May Lwin, MB

    Clinical research fellow
    University of Leeds, Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, LS2 9JT, United Kingdom
    Leeds, England, United Kingdom

  • SD

    Søren Zöga Diederichsen, PhD, MB

    Cardiology Fellow
    Copenhagen University Hospital - Rigshospitalet, Denmark

  • Sven Plein, MD, PhD

    Professor of Cardiology
    Leeds Institute of Cardiovascular and Metabolic Medicine
    Leeds, England, United Kingdom

  • Pankaj Garg, MD, PhD

    Consultant Clinical Associate Professor
    University of East Anglia, United Kingdom

  • JS

    Jesper Hastrup Svendsen

    Professor of Cardiology
    Copenhagen University Hospital - Rigshospitalet, Denmark

  • Peter P. Swoboda, PhD

    Consultant Cardiologist
    Leeds Institute of Cardiovascular and Metabolic Medicine
    Leeds, England, United Kingdom

Background: In the general population left ventricular (LV) and left atrial (LA) re-modelling is predictive of future atrial fibrillation (AF)1,2. LA and LV dilatation are common in athletes, but it is unclear if they predict occurrence of future AF. Implantable loop recorder is the gold standard for incident AF detection. We aimed to investigate in asymptomatic individuals whether cardiac morphology differed between athletes and sedentary people who developed future AF.

Methods: All participants from VENTOUX study (Ventricular arrhythmia and cardiac fibrosis in endurance experienced athlete for ILR detection of arrhythmia) were recruited and included healthy male veteran cyclists, n=106, age=58 (55-63)3. All male participants in the LOOP study (non-athletes, 70-90 years old with minimum 1 stroke risk factor who underwent a randomised-controlled trial of ILR insertion or standard care for incidence of AF who underwent cardiovascular magnetic resonance (CMR) imaging (n=128, age=75 (73-79)) were also recruited4. All underwent baseline cardiovascular health assessment, CMR imaging and ILR insertion. Participants were followed up for a period of 3 years for incidence of AF with ILR. Episodes of AF lasting 6 minutes or longer were recorded in line with current literature on clinical significance. All CMR imaging was analysed by three cardiologists for conventional markers of pathology.

Results: Baseline characteristics are shown in Table 1. In the period of follow up 62/234 (26%) developed AF, 15 from VENTOUX (14%) and 47 from LOOP (37%). On Cox regression analysis adjusted for CHARGE-AF score, athletes were no more likely to develop AF than non-athletes (HR 0.889, CI 0.28-2.9, p=0.844). In those who developed AF, athletes demonstrated larger biventricular volumes (< 0.001), larger LA indexed volume (0.009), higher indexed LV mass (< 0.001) and lower LVEF (< 0.041) than sedentary participants. In athletes who did not develop AF cardiac volumes were also significantly greater than sedentary participants (p< 0.001). Athletes who developed AF were less likely to have a dilated LA (0.015) than those who maintained sinus rhythm. LA indexed size was relatively smaller but did not reach statistical significance (p=0.094).

Conclusion: The CMR morphology of athletes who develop AF is markedly different to sedentary patients. Cardiac cavity volumes were larger in athletes irrespective of development of AF or maintenance of sinus rhythm. LA dilatation being less common in AF than sinus rhythm in athletes supports a theory that the mechanisms leading to AF are likely to be more complex than simple cavity dilatation and require further study.

Baseline characteristics and CMR measurements

Variable

n

VENTOUX

n

LOOP

Sig.

Age (years)

106

58 (55-63)

128

75 (73-79)

< 0.001

BMI (kg/m2)

106

25 (23-26)

128

27 (25-30)

< 0.001

Alcohol (units/week)

106

6 (1-16)

128

10 (3-15)

0.114

Current smoker

106

1 (1%)

128

11 (9%)

0.008

Hypertension

106

0 (0%)

128

114 (89%)

< 0.001

Diabetes mellitus

106

0 (0%)

128

46 (36%)

< 0.001

Stroke

106

0 (0%)

128

29 (23%)

< 0.001

Myocardial infarction

106

0 (0%)

128

15 (12%)

< 0.001

Heart failure

106

0 (0%)

128

6 (5%)

< 0.001

Stroke/TIA/SAE

106

0 (0%)

128

39 (30%)

< 0.001

Vascular disease

106

0 (0%)

128

19 (15%)

< 0.001

Heart rate

106

53 (49-57)

128

68 (62-76)

< 0.001

Systolic BP (mmHg)

106

119 (112-128)

128

150 (135-161)

< 0.001

Diastolic BP (mmHg)

106

74 (69-79)

128

82 (76-88)

< 0.001

Physical activity (hours/day)

105

4.8 (4.3-5.4)

127

1.4 (0.8-2.3)

< 0.001

CHADSVASC2 score

106

0 (0-0)

128

3 (3-4)

< 0.001

CHARGE AF score

106

11.9 (11.5-12.4)

128

14.4 (14.0-14.7)

< 0.001

Incident AF

106

15 (14%)

128

47 (37%)

< 0.001

LVEF (%)

106

56 (53-59)

128

58 (54-64)

< 0.001

LVEDV (mL)

106

205 (188-232)

128

151 (135-178)

< 0.001

LVEDVi (mL/m2)

106

107 (99-118)

128

73 (65-84)

< 0.001

LVESV (mL)

106

92 (81-108)

128

62 (52-78)

< 0.001

LVESVi (mL/m2)

106

48 (41-53)

128

31 (26-37)

< 0.001

LVSV (mL)

106

116 (103-131)

128

88 (77-101)

< 0.001

LVSVi (mL/m2)

106

60 (54-66)

128

43 (38-49)

< 0.001

LV mass (g)

106

135 (124-151)

128

113 (101-125)

< 0.001

LVMi (g/m2)

106

70±10

121

56±10

< 0.001

RVEF (%)

106

53±6

121

56±7

< 0.001

RVEDV (mL)

106

213 (192-240)

121

157 (135-175)

< 0.001

RVEDVi (mL/m2)

106

109 (98-121)

121

74 (66-84)

< 0.001

RVESV (mL)

106

101 (88-117)

121

68 (57-79)

< 0.001

RVESVi (mL/m2)

106

51 (45-60)

121

34 (28-38)

< 0.001

RVSV (mL)

106

113±19

121

88±19

< 0.001

RVSVi (mL/m2)

106

58 (52-64)

121

41 (37-48)

< 0.001

LAV max (mL)

106

106 (83-117)

128

70 (58-87)

< 0.001

LAVi max (mL/m2)

106

53 (43-60)

128

34 (28-43)

< 0.001

LAV min (mL)

106

45 (34-53)

128

31 (23-42)

< 0.001

LAVi min (mL/m2)

106

22 (17-27)

127

15 (11-20)

< 0.001

Dilated LA ( >53mL/m2)

106

52 (49%)

128

11 (9%)

< 0.001

LAEF (%)

106

57±7

127

57±8

0.52

Abbreviations: BMI – body mass index, BP – blood pressure, LAEF – left atrial emptying fraction,

LAV – left atrial volume, LAVi max – indexed maximum left atrial volume, LAVi min – indexed

minimum left atrial volume, LV – left ventricle, LVEDV – left ventricular end diastolic volume,

LVEDVi – indexed left ventricular end diastolic volume, LVEF – left ventricular ejection fraction,

LVESV – left ventricular end systolic volume, LVESVi – indexed left ventricular end systolic

volume, LVSV – left ventricular stroke volume, LVSVi – indexed left ventricular stroke volume,

RV – right ventricle, RVEDV – right ventricular end diastolic volume, RVEDVi – indexed right

ventricular end diastolic volume, RVEF – right ventricular ejection fraction, RVESV – right

ventricular end systolic volume, RVESVi – indexed left ventricular end systolic volume, RVSV –

right ventricular stroke volume, RVSVi – indexed right ventricular stroke volume, SAE – systemic

arterial embolism, SR – sinus rhythm, TIA – transient ischaemic attack.

CMR characteristics for VENTOUX SR, VENTOUX AF, LOOP SR and LOOP AF (SR - sinus rhythm, AF - atrial fibrillation)