Aim: The aim of this systematic literature review and
meta-analyses was to explore the relationship between physical activity and
risk of new-onset atrial fibrillation (AF) or flutter (AFlu).
Results: The search revealed 10 published studies that were
eligible for three different meta-analyses. A meta-analysis of six case-control
studies showed that risk of AF increased more than 5-fold in athletes compared
to non-athletic controls, OR=5.3 [(3.6, 7.9; 95% confidence interval (CI)],
p<0.0001. A second meta-analysis of three case-control studies showed a
significantly higher prevalence of athletes among AF populations compared to
their healthy controls, OR=4.7 (3.1-6.9; 95% CI), p<0.0001. A third meta-analysis
of three prospective large-scale long-term studies showed that moderate/high habitual
physical activity was associated with significantly reduced risk of AF compared
with none or very low intensity physical activity OR=0.89(0.83, 0.96; 95% CI),
p=002.
Conclusion: Long-term vigorous physical training or lack of physical
activity both are associated with increased risk of AF, while habitual moderate
physical activity may be associated with reduced risk. Further large-scale
prospective randomized controlled studies particularly in athletes are needed
to further confirm these findings.
Credits: Jens Rokkedal Nielsen, MD; Kristian Wachtel, MD PhD; Jawdat Abdulla, MD, PhD