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. 2020 Apr 14;41(15):1467-1475.
doi: 10.1093/eurheartj/ehaa032.

Physical activity, cardiorespiratory fitness, and cardiovascular outcomes in individuals with atrial fibrillation: the HUNT study

Lars E Garnvik  1 , Vegard Malmo  1   2 , Imre Janszky  3   4   5 , Hanne Ellekjær  6   7 , Ulrik Wisløff  1   8 , Jan P Loennechen  1   2 , Bjarne M Nes  1   2
Affiliations

Physical activity, cardiorespiratory fitness, and cardiovascular outcomes in individuals with atrial fibrillation: the HUNT study

Lars E Garnvik et al. Eur Heart J. .

Abstract

Aims: Atrial fibrillation (AF) confers higher risk of mortality and morbidity, but the long-term impact of physical activity (PA) and cardiorespiratory fitness (CRF) on outcomes in AF patients is unknown. We, therefore, examined the prospective associations of PA and estimated CRF (eCRF) with all-cause mortality, cardiovascular disease (CVD) mortality, morbidity and stroke in individuals with AF.

Methods and results: We followed 1117 AF patients from the HUNT3 study in 2006-08 until first occurrence of the outcomes or end of follow-up in November 2015. We used Cox proportional hazard regression to examine the prospective associations of self-reported PA and eCRF with the outcomes. Atrial fibrillation patients meeting PA guidelines had lower risk of all-cause [hazard ratio (HR) 0.55, 95% confidence interval (CI) 0.41-0.75] and CVD mortality (HR 0.54, 95% CI 0.34-0.86) compared with inactive patients. The respective HRs for CVD morbidity and stroke were 0.78 (95% CI 0.58-1.04) and 0.70 (95% CI 0.42-1.15). Each 1-metabolic equivalent task (MET) higher eCRF was associated with a lower risk of all-cause (HR 0.88, 95% CI 0.81-0.95), CVD mortality (HR 0.85, 95% CI 0.76-0.95), and morbidity (HR 0.88, 95% CI 0.82-0.95).

Conclusion: 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.

Keywords: Arrhythmias; Cardiovascular disease; Exercise; Population.

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Figures

Figure 1
Figure 1
(A–D) Hazard ratio and 95% confidence interval for all-cause (A), cardiovascular disease mortality (B), cardiovascular disease morbidity (C), and stroke (D) across self-reported volume of physical activity, stratified by intensity. Adjusted for attained age, sex, body mass index, cardiovascular disease, smoking, alcohol, and occupational status.
Figure 2
Figure 2
(A–D) Hazard ratio and 95% confidence interval for all-cause (A), cardiovascular disease mortality (B), cardiovascular disease morbidity (C), and stroke (D) across physical activity level in individuals with and without atrial fibrillation. Adjusted for attained age, sex, body mass index, cardiovascular disease, diabetes, hypertension, smoking, alcohol, and occupational status.
Take home figure
Take home figure
Survival probabilities for all-cause and CVD mortality according to physical activity level among individuals with atrial fibrillation.
None
See this image and copyright information in PMC

Comment in

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