TY - JOUR
T1 - Self-reported physical activity and atrial fibrillation risk
T2 - A systematic review and meta-analysis
AU - Mishima, Ricardo S.
AU - Verdicchio, Christian V.
AU - Noubiap, Jean Jacques
AU - Ariyaratnam, Jonathan P.
AU - Gallagher, Celine
AU - Jones, Dione
AU - Malik, Varun
AU - Agbaedeng, Thomas A.
AU - Middeldorp, Melissa E.
AU - Lau, Dennis H.
AU - Sanders, Prashanthan
AU - Elliott, Adrian D.
N1 - Publisher Copyright:
© 2021 Heart Rhythm Society
PY - 2021/4
Y1 - 2021/4
N2 - Background: Although physical activity (PA) is an important component of cardiovascular disease prevention and treatment, its role in atrial fibrillation (AF) risk is less well established. Objective: The purpose of this study was to systematically summarize the evidence pertaining to the relationship of PA and risk of AF. Methods: We searched the PubMed and Embase databases for prospective cohort studies reporting the risk of AF associated with a specific PA volume through March 2020. From each study, we extracted the risk associated with a given PA level, in comparison with insufficiently active (“inactive”) individuals. The reported risk was normalized to metabolic equivalent of task (MET)-minutes per week. A random-effects meta-analysis was used to compare AF risk between those who met and those who did not meet PA recommendations (450 MET-minutes per week), and a dose-response analysis between the level of PA and the risk of AF was performed. Results: Fifteen studies reporting data from 1,464,539 individuals (median age 55.3 years; 51.7% female) were included. Individuals achieving guideline-recommended level of PA had a significantly lower risk of AF (hazard ratio 0.94; 95% confidence interval 0.90–0.97; P =.001). Dose-response analysis showed that PA levels up to 1900 MET-minutes per week were associated with a lower risk of AF, with less certainty beyond that level. Conclusion: PA at guideline-recommended levels and above are associated with a significantly lower AF risk. However, at 2000 MET-minutes per week and beyond, the benefit is less clear.
AB - Background: Although physical activity (PA) is an important component of cardiovascular disease prevention and treatment, its role in atrial fibrillation (AF) risk is less well established. Objective: The purpose of this study was to systematically summarize the evidence pertaining to the relationship of PA and risk of AF. Methods: We searched the PubMed and Embase databases for prospective cohort studies reporting the risk of AF associated with a specific PA volume through March 2020. From each study, we extracted the risk associated with a given PA level, in comparison with insufficiently active (“inactive”) individuals. The reported risk was normalized to metabolic equivalent of task (MET)-minutes per week. A random-effects meta-analysis was used to compare AF risk between those who met and those who did not meet PA recommendations (450 MET-minutes per week), and a dose-response analysis between the level of PA and the risk of AF was performed. Results: Fifteen studies reporting data from 1,464,539 individuals (median age 55.3 years; 51.7% female) were included. Individuals achieving guideline-recommended level of PA had a significantly lower risk of AF (hazard ratio 0.94; 95% confidence interval 0.90–0.97; P =.001). Dose-response analysis showed that PA levels up to 1900 MET-minutes per week were associated with a lower risk of AF, with less certainty beyond that level. Conclusion: PA at guideline-recommended levels and above are associated with a significantly lower AF risk. However, at 2000 MET-minutes per week and beyond, the benefit is less clear.
KW - Atrial fibrillation
KW - Cardiorespiratory fitness
KW - Exercise
KW - Physical activity
KW - Risk
UR - http://www.scopus.com/inward/record.url?scp=85100780117&partnerID=8YFLogxK
U2 - 10.1016/j.hrthm.2020.12.017
DO - 10.1016/j.hrthm.2020.12.017
M3 - Article
C2 - 33348059
AN - SCOPUS:85100780117
SN - 1547-5271
VL - 18
SP - 520
EP - 528
JO - Heart Rhythm
JF - Heart Rhythm
IS - 4
ER -