Regular Physical Activity and Risk of Atrial Fibrillation: A Systematic Review and Meta-Analysis

Study Questions:

Does regular physical activity increase the risk for atrial fibrillation?

Methods:

This meta-analysis used the databases MEDLINE (from 1948 to November 31, 2011), EMBASE (from 1988 to 2011 week 48), and COCHRANE (from inception until the third quarter of 2011) to identify all available studies reporting cases of atrial fibrillation based on the amount of exercise. References of the retrieved articles and the review articles were also screened for eligible studies. Both prospective cohort studies and nested case-control studies examining the relation of regular physical activity and atrial fibrillation risk were eligible for inclusion. Studies on professional athletes, studies not reporting atrial fibrillation in controls, as well as traditional case-control studies, where it is difficult to establish temporality between exposure and outcome, were excluded. All of the studies used for the meta-analysis divided subjects into four or five groups based on the cumulative physical activity per week, amount and intensity of work-related physical activity, leisure-type physical activity, or amount of exercise per week. For all of the studies included, the extreme groups (i.e., maximum vs. minimal amount of physical activity) were used for the current analyses. Extracted data from the eligible studies were meta-analyzed using the fixed-effects model.

Results:

A total of four studies (follow-up periods ranged from 5.7 physical activity to 12 years) including 95,526 subjects were included in this meta-analysis. The total number of participants belonging to the extreme physical activity groups was 43,672. The pooled odds ratio for atrial fibrillation among regular exercisers was 1.08 (95% confidence interval, 0.97-1.21).

Conclusions:

The authors concluded that these data do not support a significant association between regular physical activity and increased risk for atrial fibrillation.

Perspective:

In contrast to prior studies, this meta-analysis did not demonstrate an association between physical activity and atrial fibrillation. Given the projected prevalence of atrial fibrillation, examining factors associated with atrial fibrillation makes sense; perhaps at this point, physical activity does not appear to increase one’s risk for this arrhythmia.

Clinical Topics: Anticoagulation Management, Heart Failure and Cardiomyopathies, Sports and Exercise Cardiology, Novel Agents, Acute Heart Failure, Heart Failure and Cardiac Biomarkers

Keywords: Athletes, Odds Ratio, Risk, Follow-Up Studies, Prevalence, beta-Alanine, Case-Control Studies, Benzimidazoles, Biological Markers, Heart Failure, Motor Activity, Confidence Intervals, MEDLINE


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