What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Atrial fibrillation or atrial flutter (n=3939). Intervention: Lifetime endurance exercise volume vs. ≤1778 hours (Q1). Primary outcome: AF/AFL prevalence (OR 2.16, 95% CI 1.48-3.15, p=<0.001).

What does this research mean for the field?

Higher lifetime endurance exercise volume, particularly cycling, is associated with a progressively increased risk of atrial fibrillation and atrial flutter in middle-aged males. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To investigate the relationship between endurance exercise volume and the prevalence of atrial fibrillation (AF) and atrial flutter (AFL) in middle-aged males.

May 24, 2026European Heart Journal OpenOpen Access

High lifetime endurance exercise in middle-aged men is linked to ~116% higher AF/AFL odds.

Q: What are the key findings of this study?

In middle-aged males, >12231 hours of lifetime endurance exercise was associated with increased odds of AF/AFL compared to ≤1778 hours (OR 2.16; 95% CI 1.48-3.15; p<0.001).

Q: What does this research mean for the field?

Higher lifetime endurance exercise volume, particularly cycling, is associated with a progressively increased risk of atrial fibrillation and atrial flutter in middle-aged males. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Q: What question did this study set out to answer?

To investigate the relationship between endurance exercise volume and the prevalence of atrial fibrillation (AF) and atrial flutter (AFL) in middle-aged males.

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Why the study?

Although a J-shaped relationship between exercise and AF or atrial flutter has been described, the influence of specific sport disciplines is unknown.

Does higher lifetime endurance exercise volume or specific sport discipline increase the prevalence of atrial fibrillation or flutter in middle-aged men?

Population

3939 middle-aged male candidates for the Master@Heart study

Comparison

Quartiles of lifetime endurance exercise hours (Q2-Q4 vs Q1) and sport disciplines

Design

Cross-sectional questionnaire study

Key result

In middle-aged males, >12231 hours of lifetime endurance exercise was associated with increased odds of AF/AFL compared to ≤1778 hours (OR 2.16; 95% CI 1.48-3.15; p<0.001).

Authors

JPJ De Paepe AWAstrid Witters RBRuben De Bosscher

Discussion

Member takes

Overview

High-volume endurance exercise was associated with increased AF/AFL odds; supports J-shaped relationship but leaves causality and practice change open.

Key Points

To investigate the relationship between endurance exercise volume and the prevalence of atrial fibrillation (AF) and atrial flutter (AFL) in middle-aged males.
Analyzed questionnaire data from 3939 candidates in the Master@Heart study
Participants categorized into quartiles based on lifetime endurance exercise hours
Multivariable logistic regression was used to assess the association between exercise volume/type and AF/AFL.
AF/AFL prevalence was 7.5%, increasing significantly across lifetime exercise quartiles (p < 0.001)
Q2-Q4 had significantly higher odds ratios for AF/AFL compared to Q1, with Q4 showing an OR of 2.16, 95% CI [1.48–3.15], p < 0.001
Only cycling was independently associated with AF/AFL, showing an OR of 1.51, 95% CI [1.11–2.07], p = 0.010.

Study Design

Type

Cross-Sectional (n=3,939)

Structured PICO

Does higher lifetime endurance exercise volume or specific sport discipline increase the prevalence of atrial fibrillation or flutter in middle-aged men?

Population

3939 middle-aged male candidates for the Master@Heart study

Intervention

Higher lifetime endurance exercise volume (Q2-Q4, >1778 hours) and specific sport disciplines (e.g., cycling)

Comparator

Lowest quartile of lifetime endurance exercise (Q1 ≤1778 hours)

Outcome

Prevalence of atrial fibrillation (AF) or atrial flutter (AFL)hard clinical

Main Result

Effect estimate: OR 2.16 (95% CI 1.48-3.15)

Absolute Event Rate: 9.6% vs 4.8%

p-value: p=<0.001

High-volume lifetime endurance exercise, particularly cycling, is associated with a progressively increased risk of atrial fibrillation and flutter in middle-aged men.

Cite This Study

Paepe et al. (2026) conducted a cross-sectional in Atrial fibrillation or atrial flutter (n=3,939). Lifetime endurance exercise volume vs. ≤1778 hours (Q1) was evaluated on AF/AFL prevalence (OR 2.16, 95% CI 1.48-3.15, p=<0.001). In middle-aged males, >12231 hours of lifetime endurance exercise was associated with increased odds of AF/AFL compared to ≤1778 hours (OR 2.16; 95% CI 1.48-3.15; p<0.001).

synapsesocial.com/papers/6a1295ce48a0ea16656720bc https://doi.org/10.1093/ehjopen/oeag089

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May 24, 2026European Heart Journal OpenOpen Access

High lifetime endurance exercise in middle-aged men is linked to ~116% higher AF/AFL odds.

View Full Paper

Ask AI

Bookmark

Why the study?

Although a J-shaped relationship between exercise and AF or atrial flutter has been described, the influence of specific sport disciplines is unknown.

Does higher lifetime endurance exercise volume or specific sport discipline increase the prevalence of atrial fibrillation or flutter in middle-aged men?

Population

3939 middle-aged male candidates for the Master@Heart study

Comparison

Quartiles of lifetime endurance exercise hours (Q2-Q4 vs Q1) and sport disciplines

Design

Cross-sectional questionnaire study

Key result

In middle-aged males, >12231 hours of lifetime endurance exercise was associated with increased odds of AF/AFL compared to ≤1778 hours (OR 2.16; 95% CI 1.48-3.15; p<0.001).

Authors

JPJ De Paepe AWAstrid Witters RBRuben De Bosscher

Discussion

Member takes

Overview

High-volume endurance exercise was associated with increased AF/AFL odds; supports J-shaped relationship but leaves causality and practice change open.

Key Points

To investigate the relationship between endurance exercise volume and the prevalence of atrial fibrillation (AF) and atrial flutter (AFL) in middle-aged males.
Analyzed questionnaire data from 3939 candidates in the Master@Heart study
Participants categorized into quartiles based on lifetime endurance exercise hours
Multivariable logistic regression was used to assess the association between exercise volume/type and AF/AFL.
AF/AFL prevalence was 7.5%, increasing significantly across lifetime exercise quartiles (p < 0.001)
Q2-Q4 had significantly higher odds ratios for AF/AFL compared to Q1, with Q4 showing an OR of 2.16, 95% CI [1.48–3.15], p < 0.001
Only cycling was independently associated with AF/AFL, showing an OR of 1.51, 95% CI [1.11–2.07], p = 0.010.

Study Design

Type

Cross-Sectional (n=3,939)

Structured PICO

Does higher lifetime endurance exercise volume or specific sport discipline increase the prevalence of atrial fibrillation or flutter in middle-aged men?

Population

3939 middle-aged male candidates for the Master@Heart study

Intervention

Higher lifetime endurance exercise volume (Q2-Q4, >1778 hours) and specific sport disciplines (e.g., cycling)

Comparator

Lowest quartile of lifetime endurance exercise (Q1 ≤1778 hours)

Outcome

Prevalence of atrial fibrillation (AF) or atrial flutter (AFL)hard clinical

Main Result

Effect estimate: OR 2.16 (95% CI 1.48-3.15)

Absolute Event Rate: 9.6% vs 4.8%

p-value: p=<0.001

High-volume lifetime endurance exercise, particularly cycling, is associated with a progressively increased risk of atrial fibrillation and flutter in middle-aged men.

Cite This Study

synapsesocial.com/papers/6a1295ce48a0ea16656720bc https://doi.org/10.1093/ehjopen/oeag089

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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