Figure 5 Proposed clinical approach in athletes at suspicion of atrial fibrillation (AF) and with diagnosed AF Figure 5 | Proposed clinical approach in athletes at suspicion of atrial fibrillation (AF) and with diagnosed AF. Upon clinical suspicion (palpitations, decreased performance, dizziness, and arrhythmic beats on pulse palpation), a diagnostic electrocardiogram (ECG) should be obtained before any therapeutic tools are used if AF is eventually diagnosed, and other secondary causes of AF should be ruled out. In the case of athletes with AF, shared decision-making is of particular importance. Guasch, E. & Mont, L. (2016) Diagnosis, pathophysiology, and management of exercise-induced arrhythmias Nat. Rev. Cardiol. doi:10.1038/nrcardio.2016.173