Physical Activity and Atrial Fibrillation Risk: It's Complicated; and Sex Is Critical

Stanley Nattel


Eur Heart J. 2020;41(15):1487-1489. 

In This Article

Abstract and Introduction


Atrial fibrillation (AF) is a significant and growing contributor to morbidity, mortality, and preventable stroke.[1] A variety of approaches are being applied to develop better ways to combat this expanding epidemic. One strategy that has received great interest is the control of cardiac risk factors, increasingly recognized to be an important and targetable contributor to the likelihood of AF.[1,2] An important weapon in the fight against uncontrolled risk factors is exercise, known to have beneficial effects against a range of adverse risk predictors such as obesity, diabetes, hypertension, and dyslipidaemia. However, there is evidence that high levels of exercise, especially endurance training, can promote AF.[3] These contradictory effects have been difficult to sort out in epidemiological studies, most of which support a simple protective effect; however, the available studies have been limited by relatively small sample sizes and few patients in any given study that achieve regular high-level physical activity.