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Shared decision making in athletes with cardiovascular disease: what we can learn from a masters athlete
  1. Roshan Patel1,
  2. Susil Pallikadavath2,3,
  3. Matthew P M Graham-Brown3,4 and
  4. Anvesha Singh3
  1. 1Leicester Medical School, College of Life Sciences, University of Leicester, Leicester, UK
  2. 2College of Life Sciences, University of Leicester, Leicester, UK
  3. 3Departmet of Cardiovascular Sciences, University of leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
  4. 4John Walls Renal Unit, Leicester General Hospital, Leicester, UK
  1. Correspondence to Dr Susil Pallikadavath; susil.pallikadavath{at}


A 75-year-old male cyclist began suffering from palpitations on exertion. Symptoms terminated spontaneously with cessation of physical activity. The episodes caused significant distress with an impact on physical performance and quality of life. An echocardiogram showed a dilated left atrium, and an exercise ECG demonstrated that episodes of atrial fibrillation developed when his ventricular rate was above 140 beats per minute. Rate control could not be offered due to a history of sinus bradycardia nor rhythm control due to low likelihood of success. Anticoagulant therapy was commenced but discontinued at patient request as he considered risks to outweigh benefits given his desire to continue cycling. Management of athletes with atrial fibrillation is based on guidelines for the general population; however, treatment goals for athletes may differ. Shared decision making is essential to allow patients to make informed decisions about their care, accepting that individuals view treatment risks and benefits differently.

  • arrhythmias
  • healthcare improvement and patient safety
  • cardiovascular medicine
  • sports and exercise medicine

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  • Twitter @Patel96Rosh, @SusilPallikada1

  • Contributors RP: conceptualisation, methodology, data curation, writing (both), visualisation, project administration, formal analysis. SP: conceptualisation, methodology, data curation, writing (both), visualisation, project administration, formal analysis. MPMG-B: conceptualisation, writing(both), visualisation. AS: conceptualisation, writing (both), visualisation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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