Abstract
Introduction: Whereas physical activity (PA) reduces IHD and stroke, effects on atrial fibrillation (AF) are controversial, with concern that vigorous PA (VPA) or even moderate PA (MPA) could increase AF. In addition, little is known about the association between sedentary activity (SA) and AF. Methods: We prospectively investigated habitual PA and new-onset AF in 28,169 US men age 68±9 years and free of AF in 2002. PA was assessed biennially via validated questionnaires including 11 recreational PAs and 6 SAs. MET-hours/week of MPA (MET<=6), VPA (MET>6), TPA (total PA), and hours/week of SA were quantified every 4 years from 1986 to 2010, and cumulatively averaged to assess long-term effects. Incident AF was evaluated from 2002 (first year of assessment) to 2010, based on self-reported physician diagnosis that was further confirmed by a supplementary questionnaire (positive predictive value 95% vs. medical records). We separately evaluated symptomatic vs. asymptomatic AF, based on prior evidence for ascertainment bias of the latter in this cohort (healthier people being more likely to be seen and diagnosed by their physician). Cox models estimated risk across quintiles of MPA, VPA, TPA, and SA. Results: During 231,108 person years of follow-up, 782 incident AF cases were confirmed (493 symptomatic, 283 asymptomatic, 6 symptoms unknown). In multivariable analyses, there was no significant association between MET-hours/week of MPA, VPA, or TPA and risk of symptomatic AF (p-value < 0.05) (Table). Also, hours/week of SA and TV watching were not associated with AF risk. These results remained the same after mutual adjusting for other activities, after further adjusting for potential confounders or mediators, or after excluding baseline CVD. Similar results were seen for asymptomatic and total AF. Conclusion: In this cohort of middle-aged men, neither PA nor SA was significantly associated with risk of AF.
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