PAFIYAMA syndrome: prevention is better than cure

We have recently purposed the definition of a new syndrome: strenuous endurance exercise-related atrial fibrillation (AF) under the acronym of ‘PAFIYAMA’ (‘paroxysmal AF in young and middle-aged athletes’). This syndrome may be the consequence, at least in part, of atrial fibrotic remodeling [increased left atrial (LA) size]. Although the management of this syndrome has deeply discussed, prevention is still in embryo. A number of circulation biomarkers, including proteins, cytokines and microRNA (miRNA) have been associated with cardiac adaptations to strenuous training and fibrosis. In particular, due to their involvement in a wide array of cardiac pathways under both physiological and pathological conditions, miRNA are deeply involved in cardiac biology, so that