Key result
Physical activity linked to reduced risk of incident atrial fibrillation and ventricular arrhythmias.
Why the study?
Does physical activity reduce the risk of incident arrhythmias in adults aged 40-69 years?
Cohort (n=402,406)
Does physical activity reduce the risk of incident arrhythmias in adults aged 40-69 years?
Hazard Ratio: 0.85 (95% CI 0.74–0.98)
Self-reported physical activity is associated with a significantly reduced risk of incident atrial fibrillation and ventricular arrhythmias in a large population-based cohort.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“an analysis of over 400,000 people found that those who said they did between 150-300 minutes of moderate-to-vigorous intensity physical activity per week had a 10-15% lower risk of developing atrial fibrillation compared to those who were inactive. Higher levels of exercise may only be protective in females. The study also found that exceeding these recommendations by up to three times was further protective for females but not males, with around 20% lower risk of atrial fibrillation.”
Supports continued emphasis on physical activity; leaves open causality for arrhythmia prevention pending RCTs to inform practice.
AIMS: Physical activity reduces cardiovascular disease burden and mortality, although its relationship with cardiac arrhythmias is less certain. The aim of this study was to assess the association between self-reported physical activity and atrial fibrillation (AF), ventricular arrhythmias and bradyarrhythmias, across the UK Biobank cohort. METHODS AND RESULTS: We included 402 406 individuals (52.5% female), aged 40-69 years, with over 2.8 million person-years of follow-up who underwent self-reported physical activity assessment computed in metabolic equivalent-minutes per week (MET-min/wk) at baseline, detailed physical assessment and medical history evaluation. Arrhythmia episodes were diagnosed through hospital admissions and death reports. Incident AF risk was lower amongst physically active participants, with a more pronounced reduction amongst female participants [hazard ratio (HR) for 1500 vs. 0 MET-min/wk: 0.85, 95% confidence interval (CI) 0.74-0.98] than males (HR for 1500 vs. 0 MET-min/wk: 0.90, 95% CI 0.82-1.0). Similarly, we observed a significantly lower risk of ventricular arrhythmias amongst physically active participants (HR for 1500 MET-min/wk 0.78, 95% CI 0.64-0.96) that remained relatively stable over a broad range of physical activity levels between 0 and 2500 MET-min/wk. A lower AF risk amongst female participants who engaged in moderate levels of vigorous physical activity was observed (up to 2500 MET-min/wk). Vigorous physical activity was also associated with reduced ventricular arrhythmia risk. Total or vigorous physical activity was not associated with bradyarrhythmias. CONCLUSION: The risk of AF and ventricular arrhythmias is lower amongst physically active individuals. These findings provide observational support that physical activity is associated with reduced risk of atrial and ventricular arrhythmias.
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Elliott et al. (2020) conducted a cohort in Incident arrhythmias (n=402,406). Physical activity vs. 0 MET-min/wk was evaluated on Incident atrial fibrillation in female participants (HR 0.85, 95% CI 0.74-0.98). Physical activity (1500 vs 0 MET-min/wk) was associated with lower risk of incident atrial fibrillation in females (HR 0.85; 95% CI 0.74-0.98) and males (HR 0.90; 95% CI 0.82-1.0).
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