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J Atr Fibrillation. 2013 Feb 12;5(5):789. doi: 10.4022/jafib.789. eCollection 2013 Feb-Mar.

The Relationship Between Physical Activity and Risk of Atrial Fibrillation-A Systematic Review and Meta-Analysis.

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Division of Cardiology,Copenhagen, Denmark.
Department of Medicine,Copenhagen, Denmark.
Glostrup University Hospital,Copenhagen, Denmark.


Aim: The aim of this systematic literature review and meta-analyses was to explore the relationship between physical activity and risk of new-onset atrial fibrillation (AF) or flutter (AFlu). Results: The search revealed 10 published studies that were eligible for three different meta-analyses. A meta-analysis of six case-control studies showed that risk of AF increased more than 5-fold in athletes compared to non-athletic controls, OR=5.3 [(3.6, 7.9; 95% confidence interval (CI)], p<0.0001. A second meta-analysis of three case-control studies showed a significantly higher prevalence of athletes among AF populations compared to their healthy controls, OR=4.7 (3.1-6.9; 95% CI), p<0.0001. A third meta-analysis of three prospective large-scale long-term studies showed that moderate/high habitual physical activity was associated with significantly reduced risk of AF compared with none or very low intensity physical activity OR=0.89(0.83, 0.96; 95% CI), p=002 Conclusions: Long-term vigorous physical training or lack of physical activity both are associated with increased risk of AF, while habitual moderate physical activity may be associated with reduced risk. Further large-scale prospective randomized controlled studies particularly in athletes are needed to further confirm these findings.

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