Key result
Higher exercise capacity linked to ~9% lower incident AF risk per MET.
Why the study?
AF is associated with cardiovascular morbidity and mortality, making it important to identify modifiable risk factors such as exercise capacity.
Does poorer exercise capacity increase the risk of incident atrial fibrillation in healthy adults?
Case-Control (n=1,712)
No
Does poorer exercise capacity increase the risk of incident atrial fibrillation in healthy adults?
Effect estimate: OR 0.91 (95% CI 0.83-0.98)
Poorer exercise capacity, as measured by peak VO2 and maximal METs, is independently associated with an increased risk of incident atrial fibrillation in healthy adults.
Hypothesis-generating for AF risk stratification by fitness; leaves open whether improving exercise capacity reduces incident AF.
BACKGROUND/AIMS: Atrial fibrillation (AF) is a common arrhythmia and is associated with cardiovascular morbidity and mortality. It is important to identify and control the modifiable risk factors of AF. We aimed to examine the association of exercise capacity with the risk of incident AF within 3 years in healthy subjects. METHODS: We evaluated asymptomatic adults who had undergone more than two consecutive health checkups. We included subjects who exhibited normal sinus rhythm on the first health examination and who developed AF on the second or subsequent health examinations. Subjects who underwent cardiopulmonary exercise testing within 3 years before the diagnosis of AF were examined. RESULTS: The study population in the analyses included 428 cases (mean age 58.4 ± 7.6 yr, male 95.6%). There were significant differences in maximal systolic blood pressure (SBP; case 169.4 ± 24.2 vs. control 173.9 ± 22.3 mmHg), peak VO2 (29.5 ± 5.4 vs. 30.4 ± 4.8 mL/kg per minute), and maximal metabolic equivalents (METs; 8.5 ± 1.6 vs. 8.7 ± 1.4) between the two groups. In the multivariable logistic models, adjusted odds ratios were 0.99 for maximal SBP (95% confidence interval [CI] 0.98-0.99), 0.97 for peak VO2 (95% CI 0.95-0.99), and 0.91 for maximal METs (95% CI 0.83-0.98). CONCLUSION: We demonstrated that poorer exercise capacity was associated with the development of AF in a healthy population. A prospective, systematic trial is necessary to confirm that appropriate exercise training will be beneficial in preventing the development of AF in such patients.
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Kim et al. (2023) conducted a case-control in Incident atrial fibrillation (n=1,712). Exercise capacity (maximal METs) was evaluated on Incident atrial fibrillation per 1 MET increase (OR 0.91, 95% CI 0.83-0.98). In healthy adults, higher exercise capacity was associated with a lower risk of incident atrial fibrillation, with every 1 MET increase reducing the risk by 9% (adjusted OR 0.91).
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