Game changer? A sporting indication to implant a left atrial appendage closure device in a rugby player with atrial fibrillation: a case report

European Heart Journal. Case Reports
Andre Briosa E GalaTimothy Betts

Abstract

Caring for athletes with cardiac disease requires an approach that caters to the specific needs of the athlete. A 27-year-old professional rugby player was admitted with decompensated heart failure and atrial fibrillation (AF). Transthoracic echocardiogram showed features in keeping with a dilated cardiomyopathy with severe left ventricular (LV) systolic impairment. He made good progress on evidence-based heart failure medication and his LV systolic function returned to normal. He failed to maintain sinus rhythm with cardioversion and remained in persistent AF. He then suffered a transient ischaemic attack despite appropriate anticoagulation. At 1-year follow-up, he was asymptomatic and against medical advice continued to play competitive rugby whilst taking rivaroxaban. He subsequently underwent implantation with a percutaneous left atrial appendage occlusion device, allowing him to discontinue anticoagulation, reduce his bleeding risk and resume his career, whilst simultaneously lowering the thromboembolic risk. Counselling should include different management options aimed at minimizing the risks to athletes if they to return to competitive sports. Left atrial appendage occlusion devices are a suitable AF-related stroke preve...Continue Reading

References

Sep 27, 2006·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Hein HeidbüchelUNKNOWN Study Group on Sports Cardiology of the European Association for Cardiovascular Prevention and Rehabilitation
Jun 13, 2013·European Heart Journal·Kasper AndersenJohan Sundström
Jan 24, 2015·Journal of the American College of Cardiology·Leif FribergAndreas Terént
Mar 31, 2016·Stroke; a Journal of Cerebral Circulation·Raed A JoundiUNKNOWN Stroke Outcomes Research Working Group
Aug 28, 2016·European Heart Journal·Paulus KirchhofUNKNOWN ESC Scientific Document Group
May 16, 2018·JACC. Clinical Electrophysiology·N A Mark Estes, Christopher Madias
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