It is a name synonymous with Australian sporting folklore.
By the time the Oarsome Foursome’s James Tomkins took part in the Beijing Olympic trials in 2008, he had won three Olympic gold medals and was a seven-time world champion.
But on this particular day, he was not feeling himself. as the crew went through their practice pieces, he could barely produce any power.
“I was absolutely knackered,” he saeid.
“I’ve never been more exhausted in my life, and I could sort of feel like a weird, irregular heartbeat.”
Tomkins was taken to see a cardiologist, who diagnosed him with atrial fibrillation.
Atrial fibrillation (AF) is a common heart rhythm disorder that is associated with increased risk of stroke and heart failure, while the amount of exercise someone undertakes can affect their propensity to develop it.
According to Professor André La Gerche, an expert on the effects of exercise on the heart, there are two types of people most likely to develop AF: “people who do no exercise, and people who do lots of exercise.”
A study by Dr André La Gerche (left) found elite male rowers like James Tomkins (right) were at an increased risk of developing atrial fibrillation. (Supplied: Victor Chang Research Institute)
It is a fact that has puzzled researchers and elite athletes like Tomkins, given the number of benefits exercise has on general health, including lower risk of cardiovascular disease more generally and type 2 diabetes.
So why are some elite athletes at risk of AF, and does that mean there is such a thing as too much exercise?
Do genetics or exercise increase athletes’ risk?
Dr La Gerche and his team then turned their attention to why elite male rowers were at such elevated risk of AF.
As he explained, there are both genetic and exercise-related influences on the development of AF.In this particular study,the research team were able to conclude that it was exercise,not genetic factors,which led to athletes’ increased risk of AF.
“We found that genetic factors explained some of the AF in athletes, but no more so than the general population,” Dr La Gerche said.
“We can now say that atrial fibrillation in athletes is due to a kind of excess exercise.”
However, Dr La Gerche was quick to qualify that he did not want to scare people off exercise.
“I’m pretty biased, because in my clinic I see people who have a lot of medical illness from a lack of exercise,” he said.”I’d been drinking a bit that day, had a bit of a viral load, and drank an iced Margarita, which my specialist said shocked my heart and put me in AF,” tomkins said.
Alcohol is a well-known risk factor for AF, while Dr la Gerche’s study showed athletes tended to have “extreme” relationships with alcohol, either drinking in excess, or very little.
This has since led to tomkins committing to reducing his alcohol intake, while he argues it is important for everyone – not just athletes – to drink in moderation.
Should elite rowers be screened for atrial fibrillation?
The results of Dr La Gerche’s study also raise the question of whether elite rowers (or other endurance athletes) should be screened for AF.
Part of the problem with identifying AF is that not everyone who experiences it will feel as awful as tomkins has.