Tests how heart ablation affects exercise performance in endurance athletes with atrial fibrillation
Studies how a heart rhythm procedure affects fitness in endurance athletes with irregular heartbeat.
Plain-language title generated from the registry record
Registry title: Performance After Cardiac Ablation in Endurance Athletes for Atrial Fibrillation
Key facts
- Where
- Antwerp, Genk, Hasselt, and Leuven, BelgiumSee the 4 sites
Could this be for you?
Answer for yourself. This is not a decision: only the study team can say whether you can take part.
- Are you between 18 and 80 years old?
Source: NCT07726056, who can take part
Where in Belgium
- Universitair Ziekenhuis AntwerpenAntwerp, BelgiumTaking people
- ZOL GenkGenk, BelgiumTaking people
- Jessa Hospital, Department of CardiologyHasselt, BelgiumTaking people
- UZ LeuvenLeuven, BelgiumTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- University Hospital of Leuven Leuven
- Trial code
- NCT07726056
- Record updated
- 27 July 2026
- Original description
The relationship between exercise and atrial fibrillation (AF) seems to follow a J-shaped curve: while moderate activity reduces AF risk, both insufficient and excessive endurance exercise increase susceptibility. In athletes, standard treatments such as antiarrhythmic drugs often provide only partial symptom control and may impair performance through fatigue, chronotropic incompetence and side effects. Pulmonary vein isolation (PVI) may offer a more definitive therapeutic option but carries risks of atrial fibrosis, stiffening, and altered autonomic regulation, which may also influence exercise capacity. The investigators hypothesize that ablation will have a significant impact-either beneficial or detrimental-on the physical performance of athletes with AF. However, existing evidence is limited to small studies with inconsistent findings, underscoring the need for a dedicated study.Read full original descriptionShow less
Performance After Cardiac Ablation in Endurance Athletes for Atrial Fibrillation
The relationship between exercise and atrial fibrillation (AF) seems to follow a J-shaped curve: while moderate activity reduces AF risk, both insufficient and excessive endurance exercise increase susceptibility. In athletes, standard treatments such as antiarrhythmic drugs often provide only partial symptom control and may impair performance through fatigue, chronotropic incompetence and side effects. Pulmonary vein isolation (PVI) may offer a more definitive therapeutic option but carries risks of atrial fibrosis, stiffening, and altered autonomic regulation, which may also influence exercise capacity. The investigators hypothesize that ablation will have a significant impact-either beneficial or detrimental-on the physical performance of athletes with AF. However, existing evidence is limited to small studies with inconsistent findings, underscoring the need for a dedicated study.
This prospective, multicentre interventional study will assess the effects of cardiac ablation in 100 endurance athletes with AF. Participants will undergo comprehensive pre- and post-ablation phenotyping, including electrocardiogram (ECG), cardiopulmonary exercise testing (CPET), echocardiography, Holter monitoring, and detailed training data collection (efficiency factor, acute and chronic training load). Clinical follow-up will extend to 12 months post-ablation.
The primary endpoint is the change in peak VO₂ (mL/kg/min) measured before ablation and after the procedure.
Secondary analyses will explore:
* Autonomic adaptations: including changes in maximum heart rate, heart rate recovery, heart rate reserve, and heart rate variability. * Cardiac function: alterations in diastolic and atrial function assessed by echocardiography. * Training and performance: objective measures such as efficiency factor, decoupling, functional threshold power, critical power, and acute and chronic training load. * Technique comparison: differences in outcomes between pulsed field and radiofrequency ablation (e.g. atrial function, troponin release, …). * Sex-specific effects: recognising the underrepresentation of women in sports cardiology research, the investigators will include female athletes according to incidence and evaluate potential differences in treatment response between sexes. * Predictors of AF recurrence in endurance athletes
Inclusion: Age 18-80 years; Participation in endurance sports (≥4 hours/week); Diagnosis of atrial fibrillation; Capturing training data through commercially available platforms (e.g. Strava, TrainingPeaks, …) or willingness to start collecting training data and working with these commercially available platforms prospectively.
Exclusion: History of cardiovascular disease (including ischemic heart disease, cardiomyopathy, valvular heart disease, primary electrical disorders, or congestive heart failure); No training data available; Active smoking.