Accelerometer-derived physical activity and risk of atrial fibrillation

Abstract

Aims Physical activity may be an important modifiable risk factor for atrial fibrillation (AF), but associations have been variable and generally based on self-reported activity. Methods and results We analysed 93 669 participants of the UK Biobank prospective cohort study without prevalent AF who wore a wrist-based accelerometer for 1 week. We categorized whether measured activity met the standard recommendations of the European Society of Cardiology, American Heart Association, and World Health Organization [moderate-to-vigorous physical activity (MVPA) ≥150 min/week]. We tested associations between guideline-adherent activity and incident AF (primary) and stroke (secondary) using Cox proportional hazards models adjusted for age, sex, and each component of the Cohorts for Heart and Aging Research in Genomic Epidemiology AF (CHARGE-AF) risk score. We also assessed correlation between accelerometer-derived and self-reported activity. The mean age was 62 ± 8 years and 57% were women. Over a median of 5.2 years, 2338 incident AF events occurred. In multivariable adjusted models, guideline-adherent activity was associated with lower risks of AF [hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.75–0.89; incidence 3.5/1000 person-years, 95% CI 3.3–3.8 vs. 6.5/1000 person-years, 95% CI 6.1–6.8] and stroke (HR 0.76, 95% CI 0.64–0.90; incidence 1.0/1000 person-years, 95% CI 0.9–1.1 vs. 1.8/1000 person-years, 95% CI 1.6–2.0). Correlation between accelerometer-derived and self-reported MVPA was weak (Spearman r = 0.16, 95% CI 0.16–0.17). Self-reported activity was not associated with incident AF or stroke. Conclusions Greater accelerometer-derived physical activity is associated with lower risks of AF and stroke. Future preventive efforts to reduce AF risk may be most effective when targeting adherence to objective activity thresholds.

Sex-Specific Exposure–Effect Relationship Between Physical Activity and Incident Atrial Fibrillation in the General Population: A Dose–Response Meta-Analysis of 16 Prospective Studies

“…Third, nearly all the included studies assessed selfreported PA exposure, which might be prone to recall bias and overestimation. However, a recently published article showed an inverse association between PA and AF by using accelerometer measurements (51), which confirms our main results. Specifically, they found a weak correlation between accelerometer assessment and self-reported PA and a nonsignificant AF benefit from self-reported exercise.…”

Association Between Device-Measured Physical Activity and Incident Heart Failure: A Prospective Cohort Study of 94 739 UK Biobank Participants

“…However, HF was not included as an outcome. 30 Several studies have examined device-measured PA and overall CVD risk by intensity but not in HF. Contrary to our results, a study showed that VPA, but not MPA or LPA, was associated with a lower risk of stroke.…”

The year in cardiovascular medicine 2021: arrhythmias

“…A separate LOOP analysis assessed physical activity measured through the loop recorder showing that a 1 h reduction in average daily physical activity was associated with an increased odds of AF onset the next day by ≈25%, 24 a finding supported by a recent UK Biobank analysis using a wrist-based accellerometer. 25 These data strengthen the evolving links between modifiable risk factors, physical activity, and AF providing a foundation for new tools to evaluate and intervene in lifestyle modification programmes. 26 …”

“… 7 Stopping consuming alcohol after detection of AF may reduce stroke; 5 it may also reduce the recurrence of AF after ablation. 6 Less AF 24 , 25 and stroke 25 was also seen with higher levels of physical activity (PA) as measured by modern day monitoring technology (#) in LOOP trial 24 and UK Biobank. 25 Also from the UK Biobank: long-term night shift work may cause AF.…”

“… 6 Less AF 24 , 25 and stroke 25 was also seen with higher levels of physical activity (PA) as measured by modern day monitoring technology (#) in LOOP trial 24 and UK Biobank. 25 Also from the UK Biobank: long-term night shift work may cause AF. 8 …”