Congratulations Turid Apelland

By K.S.F on 9. December 2025 • ( 0 )

Cand.med. Turid Apelland at Institute of Clinical Medicine defended the thesis “Atrial fibrillation in endurance athletes. Arrhythmia monitoring, symptoms and quality of life, and safety of exercise” for the degree of PhD 21.11.2025

From the left: Principal Supervisor Chief Physician Marius Myrstad, Vestre Viken HF, Chair of the evaluation committee: Professor II Kristine K. Sahlberg, University of Oslo, Professor Erik Øie, University of Oslo, Second opponent: Cardiology Fellow Søren Zöga Diederichsen, Copenhagen University Hospital Rigshospitalet, First opponent: Professor Mats Börjesson, University of Gothenburg, Professor and leader of the Research Department at Bærum Hospital Arnljot Tveit, Co-supervisor Professor Jan Pål Loennechen, St. Olav’s Hospital, Trondheim

Summary

Endurance athletes have increased risk of atrial fibrillation (AF). Despite lack of data, athletes are often advised to detrain after an AF diagnosis. However, studies have shown that many athletes prefer to uphold their exercise level irrespective of their diagnosis.

The aims of the thesis were to assess clinical characteristics, atrial fibrillation burden, symptoms and quality of life in endurance athletes with paroxysmal atrial fibrillation, to study safety of high-intensity exercise after an AF diagnosis, and to assess the quality of patch ECG recordings for arrhythmia detection in vigorously active athletes.

Participants were endurance athletes with paroxysmal AF and no AF-related comorbidities included in an ongoing randomised controlled trial on effects of tailored training adaption.

The athletes received an insertable cardiac monitor for continuous arrhythmia monitoring. Sports watches and chest-straps were used to record exercise. AF-related symptoms and quality of life were assessed using the Atrial Fibrillation Effect on Quality-of-Life Questionnaire.

Patch ECG was feasible for arrhythmia-detection in highly active endurance athletes, but ECG quality diminished in sports involving strenuous upper body work such as running and X-country skiing.

Despite low AF burden, 53% had clinically relevant symptoms, and 30% had reduced quality of life which was associated with AF burden above median and episode duration above one hour.

Variations between the athletes highlight the need for individually tailored management.

There were no serious adverse events or ventricular tachycardias during 1,722 hours of exercise, of which 592 hours of high or very high intensity.

AF episodes occurred less often during or subsequently following exercise compared to unrelated to exercise.