This Article Free upon publication Full Text Full Text (PDF) All Versions of this Article: 118/8/800    most recent CIRCULATIONAHA.108.785626v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mozaffarian, D. Articles by Siscovick, D. Search for Related Content PubMed PubMed Citation Articles by Mozaffarian, D. Articles by Siscovick, D. Pubmed/NCBI databases Medline Plus Health Information Atrial Fibrillation Exercise for Children Exercise for Seniors Exercise and Physical Fitness Related Collections Behavioral/psychosocial - treatment Primary prevention Exercise/exercise testing/rehabilitation Arrhythmias, clinical electrophysiology, drugs Epidemiology Related Article

(Circulation. 2008;118:800-807.)
© 2008 American Heart Association, Inc.

Arrhythmia/Electrophysiology

Physical Activity and Incidence of Atrial Fibrillation in Older Adults

The Cardiovascular Health Study

Dariush Mozaffarian, MD, DrPH; Curt D. Furberg, MD, PhD; Bruce M. Psaty, MD, PhD; David Siscovick, MD, MPH

From the Division of Cardiovascular Medicine and Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, and Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston, Mass (D.M.); Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.D.F.); and Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology, University of Washington (B.M.P., D.S.), and Center for Health Studies, Group Health (B.M.P.), Seattle, Wash.

Correspondence to Dr Mozaffarian, 665 Huntington Ave, Bldg 2-319, Boston, MA 02115. E-mail dmozaffa{at}hsph.harvard.edu

Received April 10, 2008; accepted June 23, 2008.

Background— Vigorous exertion and endurance training have been reported to increase atrial fibrillation (AF). Associations of habitual light or moderate activity with AF incidence have not been evaluated.

Methods and Results— We prospectively investigated associations of leisure-time activity, exercise intensity, and walking habits, assessed at baseline and updated during follow-up visits, with incident AF, diagnosed by annual 12-lead ECGs and hospital discharge records, from 1989 to 2001 among 5446 adults 65 years of age in the Cardiovascular Health Study. During 47 280 person-years of follow-up, 1061 new AF cases occurred (incidence 22.4/1000 person-years). In multivariable-adjusted analyses, leisure-time activity was associated with lower AF incidence in a graded manner, with 25% (hazard ratio [HR] 0.75, 95% confidence interval [CI] 0.61 to 0.90), 22% (HR 0.78, 95% CI 0.65 to 0.95), and 36% (HR 0.64, 95% CI 0.52 to 0.79) lower risk in quintiles 3, 4, and 5 versus quintile 1 (P for trend <0.001). Exercise intensity had a U-shaped relationship with AF (quadratic P=0.02): Versus no exercise, AF incidence was lower with moderate-intensity exercise (HR 0.72, 95% CI 0.58 to 0.89) but not with high-intensity exercise (HR 0.87, 95% CI 0.64 to 1.19). Walking distance and pace were each associated with lower AF risk in a graded manner (P for trend <0.001); when we assessed the combined effects of distance and pace, individuals in quartiles 2, 3, and 4 had 25% (HR 0.75, 95% CI 0.56 to 0.99), 32% (HR 0.68, 95% CI 0.50 to 0.92), and 44% (HR 0.56, 95% CI 0.38 to 0.82) lower AF incidence than individuals in quartile 1. Findings appeared unrelated to confounding by comorbidity or indication. After evaluation of cut points of moderate leisure-time activity (600 kcal/week), walking distance (12 blocks per week), and pace (2 mph), 26% of all new AF cases (95% CI 7% to 43%) appeared attributable to absence of these activities.

Conclusions— Light to moderate physical activities, particularly leisure-time activity and walking, are associated with significantly lower AF incidence in older adults.

---

 

CLINICAL PERSPECTIVE

Related Article:

Circulation: Clinical Summaries
Circulation 2008 118: 793-794. [Extract] [Full Text]

This article has been cited by other articles:

				G. E. Billman Cardiac autonomic neural remodeling and susceptibility to sudden cardiac death: effect of endurance exercise training Am J Physiol Heart Circ Physiol, October 1, 2009; 297(4): H1171 - H1193. [Abstract] [Full Text] [PDF]

				J. Abdulla and J. R. Nielsen Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis Europace, September 1, 2009; 11(9): 1156 - 1159. [Abstract] [Full Text] [PDF]

				L. Mont, J. Brugada, and R. Elosua Letter by Mont et al Regarding Article, "Physical Activity and Incidence of Atrial Fibrillation in Older Adults: The Cardiovascular Health Study" Circulation, February 10, 2009; 119(5): e195 - e195. [Full Text] [PDF]

				D. Mozaffarian, C. D. Furberg, B. M. Psaty, and D. Siscovick Response to Letter Regarding Article, "Physical Activity and Incidence of Atrial Fibrillation in Older Adults: The Cardiovascular Health Study" Circulation, February 10, 2009; 119(5): e196 - e196. [Full Text] [PDF]

				M. D. Smit and I. C. Van Gelder Is inflammation a risk factor for recurrent atrial fibrillation? Europace, February 1, 2009; 11(2): 138 - 139. [Full Text] [PDF]

				L. Mont, R. Elosua, and J. Brugada Endurance sport practice as a risk factor for atrial fibrillation and atrial flutter Europace, January 1, 2009; 11(1): 11 - 17. [Abstract] [Full Text] [PDF]