Key result
Moderate total physical activity was associated with a significantly lower risk of incident atrial fibrillation compared to the lowest activity quartile (HR 0.58), independent of resting heart rate.
Why the study?
While physical activity may influence resting heart rate, and low resting heart rate may increase atrial fibrillation risk, controversy remains regarding the association between physical activity and incident atrial fibrillation.
Does physical activity and resting heart rate independently affect the incidence of atrial fibrillation in the general population?
Cohort (n=8,811)
Yes
Does physical activity and resting heart rate independently affect the incidence of atrial fibrillation in the general population?
Hazard Ratio: 0.58 (95% CI 0.37–0.9)
Absolute Event Rate: 1.42% vs 2.39%
p-value: p=0.016
A moderate amount of physical activity is associated with a lower risk of incident atrial fibrillation, whereas a low resting heart rate (<60 bpm) is an independent risk factor for its development.
Supports moderate activity to mitigate AF risk; leaves open causality and need for RCTs.
While physical activity (PA) may influence resting heart rate (RHR), and a low RHR may be a risk factor for atrial fibrillation (AF), controversy exists regarding the association between PA and development of AF. Using data from a Korean, prospective population cohort, we investigated the independent effect of PA and RHR on the incidence of AF in the general population. A total of 8,811 participants aged 40-69 years were analyzed. Total PA assessed based on questionnaires was divided into quartiles, with the lowest to the highest being Q1, Q2, Q3, and Q4. During a median follow-up of 139 months, AF developed in 167 participants (1.9%). Q3 of total PA was associated with a significantly lower risk of AF than Q1 even after adjusting for RHR as a covariate, but Q4 was not. The risk of AF was higher in participants with RHR < 60 bpm than in those with RHR 70-85 bpm, and the significance persisted after adjusting for PA as a covariate. This study showed that a moderate amount of total PA was associated with a lower risk of incident AF independent of RHR and that low RHR was an independent risk factor for AF in the general Korean population.
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Choi et al. (2019) conducted a cohort in Atrial fibrillation (n=8,811). Moderate total physical activity (Q3) vs. Lowest quartile of total physical activity (Q1) was evaluated on Incidence of atrial fibrillation (HR 0.58, 95% CI 0.37-0.90, p=0.016). Moderate total physical activity was associated with a significantly lower risk of incident atrial fibrillation compared to the lowest activity quartile (HR 0.58), independent of resting heart rate.
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