Physical activity, height, and left atrial size are independent risk factors for lone atrial fibrillation in middle-aged healthy individuals
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AIMS: The aetiology of atrial fibrillation (AF) remains unknown in some patients. The aim of the study was to identify new risk factors for developing lone AF (LAF). METHODS AND RESULTS: A series of 107 consecutive patients younger than 65, seen in the emergency room for an episode of LAF of <48 h duration were included in the study. A group of 107 healthy volunteers matched for age and sex were recruited as controls. All subjects answered a validated questionnaire concerning leisure and occupational activities performed throughout their lifetimes to estimate accumulated hours of physical effort, classified in four levels of intensity. Demographic and echocardiographic measurements were also recorded. There were 69% of males and mean age was 48 +/- 11 years. AF was paroxysmal in 57% and persistent in the remaining 43%. Patients with AF performed more hours of both moderate and heavy intensity physical activity. They also were taller, and had a larger left atria, ventricle, and body surface area. At the multivariable analysis, only moderate and heavy physical activity, height, and anteroposterior atrial diameter were independently associated with LAF. CONCLUSIONS: Accumulated lifetime physical activity, height, and left atrial size are risk factors for LAF in healthy middle-aged individuals.
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Regular exercise of low or moderate intensity serves as a preventive strategy for cardiovascular disease and AF, while higher-intensity endurance exercise may lead to AF.
“Regular exercise of either low or moderate intensity seems serve as a preventive strategy for cardiovascular disease and AF, while higher-intensity endurance exercise may lead to AF [6,7,8,12,13,14,15,16,17,18,19,20,21].”
From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [7]
The Physical activity and Role of physical activity sections report that moderate activity was higher in patients with lone AF and was associated with it, contrary to the claim that moderate exercise prevents AF. The paper does support the other parts: it treats exercise as a way to prevent coronary artery disease and warns that prolonged, intense activity may increase AF risk. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredA 2 to 10 times higher frequency of AF has been shown in high-intensity endurance athletes compared to individuals who do not exercise.
“Many retrospective observational studies and meta-analyses have estimated a 2 to 10 times higher frequency of AF in high-intensity endurance athletes compared to individuals who do not exercise [6,7,8,12,13,14,15,16,17].”
From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [7]
The introduction and ‘Role of physical activity’ section state that previous studies link long-term endurance sport to increased AF risk. But this paper does not report a 2–10-fold higher AF frequency in high-intensity endurance athletes versus non-exercisers. Its Table 5 instead gives adjusted odds ratios of 5.60 and 15.11 for accumulated moderate and heavy physical activity relative to the lowest-activity group; those are not the claimed comparison or range. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAF in athletes is considered to be vagal-mediated.
“AF in athletes is considered to be vagal-mediated [7].”
From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [7]
The Results report that AF was classified as vagal in most patients, and the Role of physical activity section links greater lifetime activity with lone AF. But the paper does not establish that AF in athletes specifically is vagal-mediated; it says the mechanism behind the activity association remains unknown. Page numbers are unavailable in our copy. (LLM, conf=0.82)
Experimental — accuracy not yet measured
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- Authors
- Mont, L., Tamborero, D., Elosua, R., Molina, I., Coll-Vinent, B., Sitges, M., Vidal, B., Scalise, A., Tejeira, A., Berruezo, A., & Brugada, J.
- Affiliations
- Hospital Clínic de Barcelona (ES)
- Venue
- EP Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-01
- Volume
- 10
- Issue
- 1
- Pages
- 15-20
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2166330383
- Cited by
- 270
- References
- 38
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 9 · 2023: 11 · 2022: 6 · 2021: 20 · 2020: 16 · 2019: 15 · 2018: 22 · 2017: 11 · 2016: 22 · 2015: 23 · 2014: 18 · 2013: 24 · 2012: 20
- FWCI
- 10.23
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- EP Europace (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Funders
- Sociedad Española de Cardiología
- Universitat de Barcelona
- Universitat Autònoma de Barcelona
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- lone atrial fibrillation, physical activity, lifelong physical activity, height, left atrial size, left atrial diameter, risk factors, middle-aged adults, paroxysmal atrial fibrillation, persistent atrial fibrillation, body surface area, atrial volume
- MeSH terms
- Adult, Atrial Fibrillation, Body Height, Female, Heart Atria, Humans, Male, Middle Aged, Motor Activity, Predictive Value of Tests, Prospective Studies, Risk Factors, Multivariate Analysis, Case-Control Studies
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