Cited by 383Cardiovascular Effects of ExerciseAtrial Fibrillation Management and OutcomesPhysical Activity and Health

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Relation of Vigorous Exercise to Risk of Atrial Fibrillation

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Aizer, Anthony, Gaziano, J. Michael, Cook, Nancy R., Manson, Joann E., Buring, Julie E., Albert, Christine M.·2009·The American Journal of Cardiology

DOI 10.1016/j.amjcard.2009.01.374PMC PMC2687527

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Abstract

Limited data suggest that athletes may have a higher risk of developing atrial fibrillation (AF); however, there has been no large prospective assessment of the relation between vigorous exercise and AF. Logistic regression analyses stratified by time were used to assess the association between frequency of vigorous exercise and risk of developing AF in 16,921 apparently healthy men in the Physicians' Health Study. During 12 years of follow-up, 1,661 men reported developing AF. With increasing frequency of vigorous exercise (0, 1, 1 to 2, 3 to 4, 5 to 7 days/week), multivariate relative risks for the full cohort were 1.0 (referent), 0.90, 1.09, 1.04, and 1.20 (p = 0.04). This risk was not significantly increased when exercise habits were updated or in models excluding variables that may be in the biological pathway through which exercise influences AF risk. In subgroup analyses, this increased risk was observed only in men <50 years of age (1.0, 0.94, 1.20, 1.05, 1.74, p <0.01) and joggers (1.0, 0.91, 1.03, 1.30, 1.53, p <0.01), where risks remained increased in all analyses. In conclusion, frequency of vigorous exercise was associated with an increased risk of developing AF in young men and joggers. This risk decreased as the population aged and was offset by known beneficial effects of vigorous exercise on other AF risk factors.

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Result
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Effect of Years of Endurance Exercise on Risk of Atrial Fibrillation and Atrial Flutter
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Self-citation
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“In the Physicians Health Study, the relative risk of AF increased in joggers practising more than 3 or 4 days a week.(60) Thus, limiting endurance training is the most important recommendation in athletes with AF.”
Background
Exercise effects on cardiovascular disease: from basic aspects to clinical evidence
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Long-Term Incidence of Atrial Fibrillation and Stroke Among Cross-Country Skiers: Cohort Study of Endurance-Trained Male and Female Athletes
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“There are also limited data suggesting that regular moderate-intensity exercise, as recommended by national and international guidelines on PA and health, may increase the risk of developing AF.(6,8,10) This has not been a consistent finding.”
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“level of exertion is equivalent to jogging, then a greater prevalence of AF is appreciable in those jogging daily as compared with those jogging 1–2 times/week.(20) A reasonable ‘guestimate’ when consider-”
Background
A Systematic Review of the Health Benefits of Exercise Rehabilitation in Persons Living With Atrial Fibrillation
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“Twelve cohort studies (764,640 participants, 24,642 cases) investigated the association between LTPA and risk of AF [35, 38, 42, 58, 63, 67, 87, 93, 104, 115].”
Background
Atrial Fibrillation in Athletes
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BackgroundInfluential
Physical activity volume in relation to risk of atrial fibrillation. A non-linear meta-regression analysis
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Background
Exercise and Atrial Fibrillation: Prevention or Causation?
Elliott, A. D., Linz, D., Verdicchio, C. V., & Sanders, P. (2018) · Heart Lung and Circulation · doi:10.1016/j.hlc.2018.04.296 · Cited by 65
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Method
Sleep Duration and Risk of Atrial Fibrillation (from the Physicians' Health Study)
Khawaja, O. A., Sarwar, A., Albert, C. M., Gaziano, J. M., & Djoussé, L. (2012) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2012.10.038 · Cited by 60
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Atrial Fibrillation in Athletes
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Background
Low heart rates predict incident atrial fibrillation in healthy middle-aged men
Grundvold, I., Skretteberg, P. T., Liestøl, K., Erikssen, G., Engeseth, K., Gjesdal, K., Kjeldsen, S. E., Arnesen, H., Erikssen, J., & Bodegard, J. (2013) · Circulation: Arrhythmia and Electrophysiology · doi:10.1161/circep.113.000267 · Cited by 60
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Background
Physical activity and risk of atrial fibrillation in the general population: meta-analysis of 23 cohort studies involving about 2 million participants
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2020 ESC Guidelines on Sports Cardiology and Exercise in Patients with Cardiovascular Disease
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Recommendations for participation in leisure-time physical activity and competitive sports in patients with arrhythmias and potentially arrhythmogenic conditions: Part 1: Supraventricular arrhythmias. A position statement of the Section of Sports Cardiology and Exercise from the European Association of Preventive Cardiology (EAPC) and the European Heart Rhythm Association (EHRA), both associations of the European Society of Cardiology
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Authors: Aizer, A., Gaziano, J. M., Cook, N. R., Manson, J. E., Buring, J. E., & Albert, C. M.
Affiliations: Brigham and Women's Hospital (US)
Corresponding author: Aizer, Anthony
ORCID: Aizer, Anthony
Gaziano, J. Michael
Cook, Nancy R.
Manson, Joann E.
Buring, Julie E.
Albert, Christine M.
Venue: The American Journal of Cardiology
Publisher: Elsevier BV
Published: 2009-06
Volume: 103
Issue: 11
Pages: 1572-1577
ISSN: 0002-9149 (ISSN-L)
DOI: 10.1016/j.amjcard.2009.01.374
PMC: PMC2687527
OpenAlex: W2070824750
Cited by: 383
References: 25
Citations by year: 2026: 9 · 2025: 12 · 2024: 17 · 2023: 37 · 2022: 19 · 2021: 21 · 2020: 32 · 2019: 23 · 2018: 31 · 2017: 21 · 2016: 30 · 2015: 22 · 2014: 24 · 2013: 23 · 2012: 22
FWCI: 13.42
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The American Journal of Cardiology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (5r01hl043851-10)
National Heart, Lung, and Blood Institute (HL-34595, HL 26490, R01‐HL043851, R01HL034595)
National Cancer Institute (R01CA040360, CA 34944, CA-097193, R01CA097193, CA 40360, R01CA047988)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
Keywords: atrial fibrillation, high-intensity exercise, exercise frequency, joggers, young men, aging, risk factors, Physicians' Health Study
MeSH terms: Adult, Age Factors, Aged, Aged, 80 and over, Atrial Fibrillation, Humans, Life Style, Male, Middle Aged, Prospective Studies, Exercise, Effect Modifier, Epidemiologic, Body Mass Index, Logistic Models, Risk Assessment

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Relation of Vigorous Exercise to Risk of Atrial Fibrillation

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