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August 29, 2026JACC AdvancesOpen Access

Moderate-to-Vigorous Intensity Physical Activity and Risk of Incident Atrial Fibrillation in Atrial Cardiomyopathy

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Key result

Each 10-minute increase in MVPA is linked to ~24% lower AF risk in atrial cardiomyopathy.

  • HR 0.76
  • 95% CI 0.62-0.93
  • P=0.029 for interaction
  • n=10,003

Why the study?

Physical activity is recommended for atrial fibrillation prevention, but its role in individuals with atrial cardiomyopathy remains unclear.

Does moderate-to-vigorous intensity physical activity reduce incident atrial fibrillation in individuals with atrial cardiomyopathy?

Population

10,003 UK Biobank participants

Comparison

Accelerometer-measured MVPA according to AtCM status

Design

Prospective cohort study

Follow-up

Median 3.2 years

Authors

MKM S KimKangbuk Samsung HospitalMKM S KimKangbuk Samsung HospitalPYPil‐Sung YangElectrophysiology

Discussion

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Overview

MVPA may modify AF risk differently by AtCM status; leaves open tailored activity guidance pending prospective trials.

Key Points

  • To evaluate the association between accelerometer-measured moderate-to-vigorous physical activity and incident atrial fibrillation stratified by atrial cardiomyopathy status.
  • Analyzed 10,003 UK Biobank participants with atrial cardiomyopathy identified using cardiovascular magnetic resonance imaging and 12-lead electrocardiography.
  • Tracked physical activity using 7-day accelerometers and evaluated incident atrial fibrillation using multivariable-adjusted Cox proportional hazards models over a median follow-up of 3.2 years.
  • Atrial cardiomyopathy was present in 4.5% of participants and conferred a higher risk of incident atrial fibrillation (HR: 3.01; 95% CI: 1.69 to 5.37).
  • Atrial cardiomyopathy status significantly modified the exercise association (P for interaction = 0.029), where each 10-minute increase in moderate-to-vigorous physical activity strongly reduced atrial fibrillation risk in participants with atrial cardiomyopathy (HR: 0.76; 95% CI: 0.62 to 0.93) versus those without (HR: 0.94; 95% CI: 0.87 to 1.01).
  • The absolute risk reduction per 10-minute increase in physical activity was 2.82 atrial fibrillation events per 1,000 person-years in the atrial cardiomyopathy cohort (difference: -2.66; 95% CI: -4.32 to -0.73; P = 0.011).

Study Design

Type

Cohort (n=10,003)

Structured PICO

Does moderate-to-vigorous intensity physical activity reduce incident atrial fibrillation in individuals with atrial cardiomyopathy?

P
Population
10,003 UK Biobank participants followed for a median of 3.2 years to evaluate the association between accelerometer-measured physical activity and incident atrial fibrillation.
E
Exposure
Higher levels of 7-day accelerometer-measured moderate-to-vigorous intensity physical activity (MVPA).
C
Comparator
Lower levels of moderate-to-vigorous intensity physical activity (analyzed per 10-minute increase).
O
Outcome
Incident atrial fibrillation (AF) over a median follow-up of 3.2 years.hard clinical

Main Result

Hazard Ratio: 0.76 (95% CI 0.62–0.93)

p-value: p=0.029 for interaction

Moderate-to-vigorous physical activity is associated with a significantly reduced risk of incident atrial fibrillation, particularly in individuals with underlying subclinical atrial cardiomyopathy.

Cite This Study

Kim et al. (2026) conducted a cohort in Atrial fibrillation and atrial cardiomyopathy (n=10,003). Moderate-to-vigorous intensity physical activity (MVPA) vs. Lower MVPA / without atrial cardiomyopathy was evaluated on Incident atrial fibrillation (HR 0.76, 95% CI 0.62-0.93, p=0.029 for interaction). Every 10-minute increase in moderate-to-vigorous physical activity was associated with a lower risk of incident atrial fibrillation in patients with atrial cardiomyopathy (HR 0.76; 95% CI 0.62-0.93).

synapsesocial.com/papers/6a92f94899ad5b8230a67edchttps://doi.org/10.1016/j.jacadv.2026.102999
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