Physical activity, resting heart rate, and atrial fibrillation: the Tromsø Study

Morseth, Bente; Graff-Iversen, Sidsel; Jacobsen, Bjarne K.; Jørgensen, Lone; Nyrnes, Audhild; Thelle, Dag S.; Vestergaard, Peter; Løchen, Maja‐Lisa

doi:10.1093/eurheartj/ehw059

Cited by 146 publications

(146 citation statements)

References 32 publications

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“…74 For recreational activity, the association appears to be J shaped, that is, moderate physical activity reduces risk of AF development, but the benefits are lost at high activity. 75 In the MESA cohort, no association was found between vigorous physical activity or total intentional exercise and incident AF, but in a subgroup of patients who reported no vigorous activity, total intentional exercise was associated with a lower AF incidence. 76 When organized in the form of exercise program tailored for age and physical ability, as was done in the CARDIO-FIT study (Impact of Cardiorespiratory Fitness on Arrhythmia Recurrence in Obese Individuals With Atrial Fibrillation), patients who achieved higher cardiorespiratory fitness were less likely to develop recurrent AF, although low cardiorespiratory fitness was an independent predictor of AF recurrence (HR, 2.75; 95% CI, 1.61-4.68).…”

Section: Impact Of Physical Activity and Obesitymentioning

confidence: 86%

Atrial Fibrillation and Hypertension

et al. 2017

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Section: Impact Of Physical Activity and Obesitymentioning

confidence: 86%

Atrial Fibrillation and Hypertension

et al. 2017

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“…In recent prospective observational cohort and trial populations, exercise training has been associated with positive benefits in patients with AF (3,4,22,23). In a recent 20,000 adult observational cohort study, investigators observed lower all-cause mortality in AF patients who self-reported regular physical activity (22).…”

Section: Discussionmentioning

confidence: 99%

Exercise Training in Patients With Chronic Heart Failure and Atrial Fibrillation

Luo

Merrill

Parikh

et al. 2017

Journal of the American College of Cardiology

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BACKGROUND The safety and efficacy of aerobic exercise in heart failure (HF) patients with atrial fibrillation (AF) has not been well evaluated. PURPOSE This study examined if outcomes with exercise training in HF vary according to AF status. METHODS HF-ACTION randomized 2331 ambulatory HF patients with ejection fraction ≤35% to exercise training or usual care. We examined clinical characteristics and outcomes (mortality/hospitalization) by baseline AF status (past history of AF or AF on baseline EKG vs. no AF) using adjusted Cox models and explored an interaction with exercise training. We assessed post-randomization AF events diagnosed via hospitalizations for AF and reports of serious arrhythmia caused by AF. RESULTS Of 2292 patients with baseline rhythm data, 382 (17%) had AF, 1602 (70%) had sinus rhythm, and 308 (13%) had “other” rhythm. Patients with AF were older and had lower peak VO2. Over a median follow-up of 2.6 years, AF was associated with a 24% per year higher rate of mortality/hospitalization (hazard ratio [HR] 1.53; 95% CI 1.34–1.74; p <0.001) in unadjusted analysis; this did not remain significant after adjustment (HR 1.15; 95% CI 0.98–1.35; p =0.09). There was no significant difference in AF event rates by randomized treatment assignment in the overall population or by baseline AF status (all p >0.1). There was no interaction between AF and exercise training on measures of functional status or clinical outcomes (all p >0.1). CONCLUSIONS AF in patients with chronic HF was associated with older age, reduced exercise capacity at baseline, and a higher overall rate of clinical events, but not a differential response to exercise training for clinical outcomes or changes in exercise capacity. Clinicaltrials.gov Identifier NCT00047437

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“…Recent studies have reported that low RHR is associated with higher incidence of AF development in various populations [22–24]. Bohn et al reported that RHR lower than 60 beats/min was associated with increased incidence of AF in 27,064 patients with high cardiovascular risk during a mean follow-up period of 4.7 years [22].…”

Section: Discussionmentioning

confidence: 99%

Resting Heart Rate and Ischemic Stroke in Patients with Heart Failure

et al. 2017

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Background: Although high resting heart rate (RHR) is known to be associated with an increased risk of mortality and hospital admission in patients with heart failure, the relationship between RHR and ischemic stroke remains unclear. This study is aimed at investigating the relationship between RHR and ischemic stroke in patients with heart failure in sinus rhythm. Methods: We examined 2,060 patients with systolic heart failure in sinus rhythm from the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction trial. RHR was determined from baseline electrocardiogram, and was examined as both a continuous variable and a categorical variable using quartiles. Ischemic strokes were identified during follow-up and adjudicated by physician review. Results: During 3.5 ± 1.8 years of follow-up, 77 patients (5.3% from Kaplan-Meier [KM] curve) experienced an ischemic stroke. The highest incidence of ischemic stroke (21/503 [KM 6.9%]) was observed in the lowest RHR quartile (RHR <64 beats/min) compared to other groups; 22/573 (KM 5.3%) in 64-70 beats/min, 13/465 (KM 3.5%) in 71-79 beats/min, and 21/519 (KM 5.4%) in RHR >79 beats/min (p = 0.693). Multivariable Cox proportional hazards analysis revealed that RHR was significantly associated with ischemic stroke (hazard ratio per unit decrease: 1.07, 95% CI 1.02-1.13, when RHR <64/beats/min; p = 0.038), along with a history of stroke or transient ischemic attack and left ventricular ejection fraction. Conclusions: In contrast to its beneficial effect on mortality and hospital re-admissions, lower RHR may increase the risk of ischemic stroke in patients with systolic heart failure in sinus rhythm.

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Physical activity, resting heart rate, and atrial fibrillation: the Tromsø Study

Cited by 146 publications

References 32 publications

Atrial Fibrillation and Hypertension

Atrial Fibrillation and Hypertension

Exercise Training in Patients With Chronic Heart Failure and Atrial Fibrillation

Resting Heart Rate and Ischemic Stroke in Patients with Heart Failure

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