Cardiovascular mortality in athletes in 50 % of cases is due to cardiovascular diseases (CVD). Among them heart arrhythmias, in particular atrial fibrillation (AF) comprise a significant part. Therefore, the assessment of risk factors for AF is extremely important in athletes. We summarize the data of recent experimental and clinical studies on the relationship of physical activity, hypertension, obesity, carbohydrate metabolism disorders, genetic aspects and AF. The diagnostic approaches to heart rhythm disorders in athletes are discussed. We also indicate the directions of further research. The pathogenetic rationale for diagnostic strategies for AF in athletes is developed.