Abstract
Although exercise prevents cardiovascular disease and mortality, vigorous exercise and endurance athletics can cause atrial fibrillation (AF). However, no large cohort study has assessed the relationship between physical activity and AF in the general population. We assessed the effect of physical activity at different energy expenditures on the incidence of AF. We studied 501,690 individuals without pre-existing AF (mean age, 47.6 ± 14.3 years; 250,664 women [50.0%]) included in the Korean National Health Insurance Service database. The physical activity level was assessed using a standardized self-reported questionnaire at baseline. During a median follow-up of 4 years, 3,443 participants (1,432 women [41.6%]) developed AF. The overall incidence of AF at follow-up was 1.79 per 1,000 person-years. The subjects who met the recommended physical activity level (500–1,000 metabolic equivalent task [MET] minutes/week) had a 12% decreased AF risk (adjusted hazard ratio [HR]: 0.88, 95% confidence interval [CI]: 0.80–0.97), but not the insufficiently (1–500 MET-minutes/week; HR: 0.94, 95% CI: 0.86–1.03) and highly active subjects (≥1,000 MET-minutes/week; HR: 0.93, 95% CI: 0.85–1.03). The recommended minimum key target range of physical activity level was associated with the maximum benefit for reduced AF risk in the general population. The dose-response relationship between physical activity level and AF risk showed a U-shaped pattern. Although exceeding the key target range attenuated this benefit, it did not increase the AF risk beyond that during inactivity.
Highlights
The potential benefit of regular physical activity in reducing atrial fibrillation (AF) risk may be considerable
We evaluated the association of physical activity level and new-onset AF in a community-based database in Korea, which includes >500,000 individuals who underwent health examinations
We found an AF risk reduction in moderate-intensity leisure-time physical activity (LTPA) (500–1,000 metabolic equivalent task (MET)-minutes/ week: HR: 0.90, 95% CI: 0.82–0.98)
Summary
The potential benefit of regular physical activity in reducing AF risk may be considerable. The relationship between physical activity level and AF risk remains unclear; the reported relationship varied among studies. The effect of different physical activity levels on the incidence of AF varies. No eligible studies have addressed whether the public health guideline-recommended physical activity level can positively affect the AF risk. The optimal target range for AF prevention remains undefined. We evaluated the association of physical activity level and new-onset AF in a community-based database in Korea, which includes >500,000 individuals who underwent health examinations. We assessed the effect of different physical activity levels on the incidence of AF and aimed to suggest the optimal target range of physical activity for AF prevention
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
