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Relation of Vigorous Exercise to Risk of Atrial Fibrillation

  • Anthony Aizer
    Correspondence
    Corresponding author: Tel: 212-263-5656; fax: 212-263-8534
    Affiliations
    Center for Arrhythmia Prevention, Brigham and Women's Hospital, Boston, Massachusetts

    Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts

    Leon H. Charney Division of Cardiology, Department of Medicine, New York University Medical Center, New York, New York
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  • J. Michael Gaziano
    Affiliations
    Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts

    Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts

    Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts

    Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts
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  • Nancy R. Cook
    Affiliations
    Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts

    Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
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  • Joann E. Manson
    Affiliations
    Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts

    Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
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  • Julie E. Buring
    Affiliations
    Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts

    Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts

    Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, Massachusetts

    Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
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  • Christine M. Albert
    Affiliations
    Center for Arrhythmia Prevention, Brigham and Women's Hospital, Boston, Massachusetts

    Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts

    Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts

    Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
    Search for articles by this author
      Limited data suggest that athletes may have a higher risk of developing atrial fibrillation (AF); however, there has been no large prospective assessment of the relation between vigorous exercise and AF. Logistic regression analyses stratified by time were used to assess the association between frequency of vigorous exercise and risk of developing AF in 16,921 apparently healthy men in the Physicians' Health Study. During 12 years of follow-up, 1,661 men reported developing AF. With increasing frequency of vigorous exercise (0, 1, 1 to 2, 3 to 4, 5 to 7 days/week), multivariate relative risks for the full cohort were 1.0 (referent), 0.90, 1.09, 1.04, and 1.20 (p = 0.04). This risk was not significantly increased when exercise habits were updated or in models excluding variables that may be in the biological pathway through which exercise influences AF risk. In subgroup analyses, this increased risk was observed only in men <50 years of age (1.0, 0.94, 1.20, 1.05, 1.74, p <0.01) and joggers (1.0, 0.91, 1.03, 1.30, 1.53, p <0.01), where risks remained increased in all analyses. In conclusion, frequency of vigorous exercise was associated with an increased risk of developing AF in young men and joggers. This risk decreased as the population aged and was offset by known beneficial effects of vigorous exercise on other AF risk factors.
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      References

        • Coelho A.
        • Palileo E.
        • Ashley W.
        • Swiryn S.
        • Petropoulos A.T.
        • Welch W.J.
        • Bauernfeind R.A.
        Tachyarrhythmias in young athletes.
        J Am Coll Cardiol. 1986; 7: 237-243
        • Hood S.
        • Northcote R.J.
        Cardiac assessment of veteran endurance athletes: a 12 year follow up study.
        Br J Sports Med. 1999; 33: 239-243
        • Karjalainen J.
        • Kujala U.M.
        • Kaprio J.
        • Sarna S.
        • Viitasalo M.
        Lone AF in vigorously exercising middle aged men: case-control study.
        BMJ. 1998; 316: 1784-1785
        • The Steering Committee of the Physicians' Health Study Research Group
        Final report in the aspirin component of the ongoing Physicians' Health Study.
        N Engl J Med. 1989; 321: 129-335
        • Page R.L.
        • Tilsch T.W.
        • Connolly S.J.
        • Schnell D.J.
        • Marcello S.R.
        • Wilkinson W.E.
        • Pritchett E.L.
        Asymptomatic or “silent” atrial fibrillation: frequency in untreated patients and patients receiving azimilide.
        Circulation. 2003; 107: 1141-1145
        • Siconolfi S.F.
        • Lasater T.M.
        • Snow R.C.K.
        • Carleton R.A.
        Self-reported physical activity compared with maximal oxygen uptake.
        Am J Epidemiol. 1985; 122: 101-105
        • Kohl H.W.
        • Blair S.N.
        • Paffenbarger Jr, R.S.
        • Macera C.A.
        • Kronenfeld J.J.
        A mail survey of physical activity habits as related to measured physical fitness.
        Am J Epidemiol. 1988; 127: 1228-1239
        • Manson J.E.
        • Grobbee D.E.
        • Stampfer M.J.
        • Taylor J.O.
        • Goldhaber S.Z.
        • Gaziano J.M.
        • Ridker P.M.
        • Buring J.E.
        • Hennekens C.H.
        Aspirin in the primary prevention of angina pectoris in a randomized trial of United States physicians.
        Am J Med. 1990; 89: 772-776
        • Heidbuchel H.
        • Anne W.
        • Willems R.
        • Adriaenssens B.
        • Van de Werf F.
        • Ector H.
        Endurance sports is a risk factor for atrial fibrillation after ablation of atrial flutter.
        Int J Cardiol. 2006; 107: 67-72
        • Mont L.
        • Sambola A.
        • Brugada J.
        • Vacca M.
        • Marrugat J.
        • Elosua R.
        • Pare C.
        • Azqueta M.
        • Sanz G.
        Long-lasting sports practice and lone atrial fibrillation.
        Eur Heart J. 2002; 23: 477-482
        • Mont L.
        • Tamborero D.
        • Elosua R.
        • Molina I.
        • Coll-Vincent B.
        • Sitges M.
        • Vidal B.
        • Scalise A.
        • Tejeira A.
        • Berruezo A.
        • Brugada J.
        Physical activity, height, and left atrial size are independent risk factors for lone atrial fibrillation in middle-aged healthy individuals.
        Europace. 2008; 11: 15-20
        • Elosua R.
        • Arquer A.
        • Mont L.
        • Sambola A.
        • Molina L.
        • Garcia-Moran E.
        • Brugada J.
        • Marrugat J.
        Sport practice and the risk of lone atrial fibrillation: a case–control study.
        Int J Cardiol. 2006; 108: 332-337
        • Baldesberger S.
        • Bauersfeld U.
        • Candinas R.
        • Sefiert B.
        • Zuber M.
        • Ritter M.
        • Jenni R.
        • Oechslin E.
        • Luthi P.
        • Scharf C.
        • et al.
        Sinus node disease and arrhythmias in the long-term follow-up of former professional cyclists.
        Eur Heart J. 2008; 29: 71-78
        • Northcote R.
        • McKillop G.
        • Todd I.
        • Canning G.
        The effect of habitual sustained endurance exercise on cardiac structure and function.
        Eur Heart J. 1990; 11: 17-22
        • Kasikcioglu E.
        • Oflaz H.
        • Akhan H.
        • Kayserilioglu A.
        • Umman B.
        • Bugra Z.
        • Erzengin F.
        Left atrial geometric and functional remodeling in athletes.
        Int J Sports Med. 2006; 27: 267-271
        • Pelliccia A.
        • Maron M.J.
        • Di Paolo F.M.
        • Biffi A.
        • Quattrini F.M.
        • Pisicchio C.
        • Roselli A.
        • Caselli S.
        • Culasso F.
        Prevalence and clinical significance of left atrial remodeling in competitive athletes.
        J Am Coll Cardiol. 2005; 46: 690-696
        • Kannel W.B.
        • Wolf P.A.
        • Benjamin E.J.
        • Levy D.
        Prevalence, incidence, prognosis and predisposing conditions for atrial fibrillation: population-based estimates.
        Am J Cardiol. 1998; 82: 2N-9N
        • Jost J.
        • Weiss M.
        • Weicker H.
        Comparison of sympatho-adrenergic regulation at rest and of the adrenoceptor system in swimmers, long-distance runners, weight lifters, wrestlers and untrained men.
        Eur J Appl Physiol Occup Physiol. 1989; 58: 596-604
        • Talan D.A.
        • Bauernfeind R.A.
        • Ashley W.W.
        • Kanakis Jr, C.
        • Rosen K.M.
        Twenty-four hour continuous ECG recordings in long distance runners.
        Chest. 1982; 1: 19-24
        • Huang J.L.
        • Wen Z.C.
        • Lee W.L.
        • Chang M.S.
        • Chen S.A.
        Changes in autonomic tone before the onset of paroxysmal atrial fibrillation.
        Int J Cardiol. 1998; 66: 275-283
        • Schuaerte P.
        • Scherlag B.J.
        • Pitha J.
        • Scherlag M.A.
        • Reynolds D.
        • Lazzara R.
        • Jackman W.M.
        Catheter ablation of cardiac autonomic nerves for the prevention of vagal atrial fibrillation.
        Circulation. 2000; 102: 2774-2780
        • Pappone C.
        • Santinelli V.
        • Manguso F.
        • Vicedomini G.
        • Gugliotta F.
        • Augello G.
        • Mazzone P.
        • Tortoriello V.
        • Landoni G.
        • Zangrillo A.
        • et al.
        Pulmonary vein denervation enhances long-term benefit after circumferential ablation for paroxysmal atrial fibrillation.
        Circulation. 2004; 109: 327-334
        • Oida E.
        • Kannagi T.
        • Moritani T.
        • Yamori Y.
        Aging alteration of cardiac vagosympathetic balance assessed through tone-entropy analysis.
        J Gerontol A Biol Sci Med Sci. 1999; 54: M219-M224