Association between physical activity and risk of incident arrhythmias in 402 406 individuals: evidence from the UK Biobank cohort

Abstract

Aims Physical activity reduces cardiovascular disease burden and mortality, although its relationship with cardiac arrhythmias is less certain. The aim of this study was to assess the association between self-reported physical activity and atrial fibrillation (AF), ventricular arrhythmias and bradyarrhythmias, across the UK Biobank cohort. Methods and results We included 402 406 individuals (52.5% female), aged 40–69 years, with over 2.8 million person-years of follow-up who underwent self-reported physical activity assessment computed in metabolic equivalent-minutes per week (MET-min/wk) at baseline, detailed physical assessment and medical history evaluation. Arrhythmia episodes were diagnosed through hospital admissions and death reports. Incident AF risk was lower amongst physically active participants, with a more pronounced reduction amongst female participants [hazard ratio (HR) for 1500 vs. 0 MET-min/wk: 0.85, 95% confidence interval (CI) 0.74–0.98] than males (HR for 1500 vs. 0 MET-min/wk: 0.90, 95% CI 0.82–1.0). Similarly, we observed a significantly lower risk of ventricular arrhythmias amongst physically active participants (HR for 1500 MET-min/wk 0.78, 95% CI 0.64–0.96) that remained relatively stable over a broad range of physical activity levels between 0 and 2500 MET-min/wk. A lower AF risk amongst female participants who engaged in moderate levels of vigorous physical activity was observed (up to 2500 MET-min/wk). Vigorous physical activity was also associated with reduced ventricular arrhythmia risk. Total or vigorous physical activity was not associated with bradyarrhythmias. Conclusion The risk of AF and ventricular arrhythmias is lower amongst physically active individuals. These findings provide observational support that physical activity is associated with reduced risk of atrial and ventricular arrhythmias.

Physical activity and risk of atrial fibrillation in the general population: meta-analysis of 23 cohort studies involving about 2 million participants

“…Given that CHD and AF share some common risk factors and the well-known inverse relationship between physical activity and CHD [6,7], one would expect that physical activity might have a beneficial effect on AF. Over the last decades, several reports have been published on the associations between physical activity and the risk of AF in the general population, but the results have been divergent; with some studies reporting decreased AF risk with regular physical activity [8][9][10] and others reporting an increased AF risk [11,12] or no evidence of an association. [13,14] Several meta-analyses have also been conducted in efforts to pool the existing evidence, but findings of these earlier reports have also been inconsistent.…”

The Feasibility of High-Intensity Interval Training in Patients with Intensive Care Unit-Acquired Weakness Syndrome Following Long-Term Invasive Ventilation

“…Physical activity (PA) reduces morbidity and mortality by reducing the burden of arrhythmias and improvement of cardiorespiratory fitness (CRF) through modulating lipid profiles, increasing aerobic capacities in adolescents, grown-ups and the elderly [3][4][5]. High-intensity interval (HIIT) and moderate continuous training (MCT) are established methods to preserve and boost endurance in professional and recreational sports as well as in patients [6][7][8].…”

Decreased plasma musclin levels are associated with potential atrial fibrillation in non-diabetic patients

“…Physical activity can enhance musclin expression in both muscles and the circulation, which improves exercise endurance (17). Some studies also reported that proper exercise could improve cardiorespiratory fitness in AF patients and prevent atrial and ventricular arrhythmias (18,38). Given this background, we speculated that decreased musclin levels would likely be involved in the occurrence and progression of AF.…”

“…A series of studies have reported the relationship of ANP or BNP with AF (12)(13)(14)(15), and NP has been recommended as a tool for the routine evaluation of patients with AF (16). Accordingly, physical exercise can up-regulate circulating musclin (17) and reduce the risk of atrial arrhythmias (18). However, musclin is found to increase insulin resistance in obesity (19) and vasoconstriction (20), which has been suggested to play a role in the onset of AF.…”