Physical fitness link to reduced atrial fibrillation risk

Physical fitness is associated with a reduced chance of developing atrial fibrillation and stroke, according to research to be presented at a major European conference this week.

A study, led by Dr Shih-Hsien Sung of the National Yang Ming Chiao Tung University, Taipei, Taiwan, which is to be presented at European Society of Cardiology Congress 2023 in Amsterdam, Netherlands, examined if fitness was related to the likelihood of developing atrial fibrillation.

It included 15,450 individuals, average age 55 and 59% of whom were men, and none had atrial fibrillation.

They had been referred for a treadmill test between 2003 and 2012 and their fitness was assessed using the Bruce protocol, in which participants walk faster and at a steeper grade in successive three-minute stages. Fitness was calculated according to the rate of energy expenditure the participants achieved, in metabolic equivalents (METs).

Participants were followed for new-onset atrial fibrillation, stroke, myocardial infarction and death and the research team analysed the associations between fitness and atrial fibrillation, stroke and major adverse cardiovascular events (MACE).

During a median follow up of 137 months, 515 participants (3.3%) developed atrial fibrillation. They found each one MET increase on the treadmill test was associated with an 8% lower risk of atrial fibrillation, 12% lower risk of stroke and 14% lower risk of MACE.

Participants were divided into three fitness levels according to METs achieved during the treadmill test: low (less than 8.57 METs), medium (8.57 to 10.72) and high (more than 10.72).

They calculated the probability of not developing atrial fibrillation over five years was 97.1%, 98.4% and 98.4% in the low, medium and high fitness groups, respectively.

Dr Sung said: “This was a large study with an objective measurement of fitness and more than 11 years of follow up. The findings indicate that keeping fit may help prevent atrial fibrillation and stroke.”

Exercise performance and the risk of incident atrial fibrillation will be presented during the session A journey through the athlete’s heart: from screening to imaging to electrical, on Friday, 25 August.

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