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. 2016 Aug 1;37(29):2307-13.
doi: 10.1093/eurheartj/ehw059. Epub 2016 Mar 10.

Physical activity, resting heart rate, and atrial fibrillation: the Tromsø Study

Bente Morseth  1 , Sidsel Graff-Iversen  2 , Bjarne K Jacobsen  3 , Lone Jørgensen  4 , Audhild Nyrnes  3 , Dag S Thelle  5 , Peter Vestergaard  6 , Maja-Lisa Løchen  7
Affiliations

Physical activity, resting heart rate, and atrial fibrillation: the Tromsø Study

Bente Morseth et al. Eur Heart J. .

Abstract

Aims: The objective was to examine the association of physical activity and resting heart rate (RHR) with hospital-diagnosed atrial fibrillation (AF) in a Norwegian cohort.

Methods and results: This prospective study included 20 484 adults (50.3% men) who participated in the third Tromsø Study survey in 1986-87. At baseline, physical activity was assessed by a validated questionnaire, and RHR was objectively measured. Participants were followed from baseline through 2010 with respect to incident cases of hospital-diagnosed AF documented on an electrocardiogram. During a mean follow-up period of 20 years (409 045 person-years), 750 participants (70.5% men) were diagnosed with AF. Compared with the low physical activity group, moderately active individuals had a 19% lower risk of any AF [adjusted hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.68-0.97], whereas highly active had similar risk of AF. Vigorously active individuals showed a non-significantly higher risk of AF (adjusted HR 1.37, 95% CI 0.77-2.43). Risk of AF increased with decreasing RHR (adjusted HR 0.92, 95% CI 0.86-0.98 for each 10 b.p.m. increase in RHR), and RHR < 50 b.p.m. was a risk factor for AF (P < 0.05).

Conclusion: In this prospective cohort study, leisure time physical activity was associated with AF in a J-shaped pattern. Moderate physical activity was associated with a reduced risk of AF, whereas higher activity levels attenuated the benefits of moderate activity. Low RHR was a risk factor for AF. Our results support the hypothesis that moderate and vigorous physical activity may affect AF risk via different pathophysiological mechanisms.

Keywords: Arrhythmia; Atrial fibrillation; Exercise; Physical activity; Resting heart rate.

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Figures

Figure 1
Figure 1
Flow chart showing the selection process for the present study.
Figure 2
Figure 2
Risk of AF in relation to leisure time physical activity at baseline: (A) overall, (B) stratified by sex*, and (C) stratified by age*. *‘High activity’ and ‘vigorous activity’ were merged into a new ‘high/vigorous activity’ category due to few participants undertaking vigorous activity.
Figure 3
Figure 3
Risk of AF in relation to occupational physical activity level at baseline.
Figure 4
Figure 4
Adjusted probability of AF in relation to physical activity.
Figure 5
Figure 5
Risk of AF in relation to change in leisure time physical activity.
Figure 6
Figure 6
Risk of AF in relation to RHR at baseline.
See this image and copyright information in PMC

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