Log in to MyACC
Physical Activity, Cardiorespiratory Fitness, and Outcomes in Atrial Fibrillation
Study Questions:
Does regular physical activity (PA) and higher estimated cardiorespiratory fitness (eCRF) in persons with atrial fibrillation (AF) impact all-cause mortality, cardiovascular disease (CVD) mortality, morbidity, and stroke?
Methods:
This Norwegian population-based cohort study followed 1,117 patients with AF at baseline who were enrolled in the HUNT3 study in 2006–2008. The endpoint was the first occurrence of the outcomes or end of follow-up in November 2015. Cox proportional hazard regression was used to examine the prospective associations of self-reported PA and eCRF with the outcomes.
Results:
Mean age was about 72 years and 61% were men. All had AF at baseline with 42% having paroxysmal AF, 15% persistent AF, and 42% permanent AF. AF patients meeting PA guidelines had lower risk of all-cause (hazard ratio [HR], 0.55) and CVD mortality (HR, 0.54) compared with inactive patients. The respective HRs for CVD morbidity and stroke were 0.78 and 0.70. Each 1-metabolic equivalent task (MET) higher eCRF was associated with a 12% lower risk of all-cause and 15% lower CVD mortality and 12% lower CV morbidity.
Conclusions:
Higher PA and CRF are associated with lower long-term risk of CVD and all-cause mortality in individuals with AF. The findings support a role for regular PA and improved CRF in AF patients, in order to combat the elevated risk for mortality and morbidity.
Perspective:
PA and fitness are associated with a decrease in incident AF, and randomized controlled trials have demonstrated that enhancing lifestyle with weight loss and exercise reduce the recurrence of AF. This important study strongly supports PA and fitness recommendations for patients with chronic AF, including consideration for paroxysmal AF, persistent AF, and chronic AF, as indications for unmonitored cardiac rehabilitation.
Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Prevention, Sports and Exercise Cardiology, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Exercise
Keywords: Arrhythmias, Cardiac, Atrial Fibrillation, Cardiac Rehabilitation, Exercise, Metabolic Equivalent, Physical Fitness, Recurrence, Secondary Prevention, Sedentary Behavior, Stroke, Weight Loss
< Back to Listings
