Investigating why the super fit get heart rhythm disorders
14 Apr 2026
Adelaide researchers are working with elite endurance athletes to unlock new insights into atrial fibrillation (AF), after evidence showed ultra-fit people are up to seven times more likely to develop the heart rhythm disorder.
Affecting around one in three Australians over the age of 45, AF is a disorder of the heart’s electrical system, often described as a short circuit, causing the heart to beat rapidly and irregularly. It significantly increases the risk of heart failure, stroke and dementia, and is the most common cause of cardiac-related hospitalisation in Australia.
While AF is strongly linked to lifestyle factors such as excess weight, high blood pressure and inactivity, endurance athletes also face a markedly higher risk, presenting a surprising paradox for researchers.
Associate Professor Adrian Elliott from the Centre for Heart Rhythm Disorders at Adelaide University and SAHMRI is working to uncover insights that could improve prevention, early detection and treatment across the broader population.
His research focuses on how sustained endurance exercise affects the heart, including changes in heart structure and electrical activity that may predispose some athletes to arrhythmia during their sporting careers or later in life.
“It’s well established that lifestyle factors such as obesity and hypertension are the major drivers of AF for most people, now we’re trying to understand why elite endurance athletes including footballers, triathletes and rowers also develop this condition,” A/Prof Elliott said.
“We’ve learned that endurance exercise places a significant load on the heart. The harder a muscle works, the more mass it builds, and over time the heart chambers can enlarge. But why does a bigger heart increase the risk of electrical instability, and how does this compare with arrhythmia in less-fit individuals? Those are the questions we need to answer.”
One approach involves detailed assessment of heart function in athletes with AF, including measuring pressures inside the heart and mapping abnormal electrical activity with advanced imaging and diagnostic tools.
Insights gained from elite athletes may ultimately benefit the broader population, helping clinicians identify AF earlier and intervene before serious complications develop.
“AF can be like the canary in the coal mine. It often causes significant symptoms and a deep sense of unwellness. While it is not usually immediately life threatening, it can be an early warning sign of more serious cardiovascular disease,” A/Prof Elliott said.
“If we can identify common underlying mechanisms, we may be able to detect AF earlier and develop more effective treatments to help people keep their hearts healthier for longer and reduce long-term strain on the health system.”
A/Prof Elliott presented his research at SAHMRI’s AFL Gather Round Festival of Footy Community Luncheon.
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SAHMRI is located on Kaurna Country. We pay respects to the Kaurna people of the Adelaide Plains and to all Aboriginal and Torres Strait Islander people. We are committed to embracing knowledge and culture as we continue our working journey to incorporate Aboriginal health research across all of our themes and further reconciliation.
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