Resting heart rate and physical activity as risk factors for lone atrial fibrillation: a prospective study of 309,540 men and women
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OBJECTIVE: To study the impact of resting heart rate and leisure time physical activity at middle age on long term risk of drug treated lone atrial fibrillation (AF). DESIGN: Longitudinal cohort study of 309 540 Norwegian men and women aged 40-45 years examined during 1985-1999 followed from 2005 through 2009. SETTING: Data from a national health screening programme were linked to the Norwegian Prescription Database (NorPD). PATIENTS: The cohort comprised 162 078 women and 147 462 men; 575 (0.4%) men and 288 women (0.2%) received flecainide and 568 men and 256 women sotalol and were defined as patients with AF. INTERVENTIONS: No interventions. MAIN OUTCOME MEASURES: The outcome was lone fibrillation defined by having at least one prescription of flecainide or sotalol registered in NorPD between 2005 and 2009. Cox proportional hazard regression models were used to assess time to first prescription. RESULTS: The risk for being prescribed these drugs increased with decreasing baseline resting heart. Adjusted hazard ratio (HR) per 10 beats/min decrease in resting heart rate for flecainide prescription was 1.26 in men (95% CI 1.17 to 1.35) and 1.15 (95% CI 1.05 to 1.27) in women. Similar effects were seen for sotalol in men, but not in women. Men who reported intensive physical activity were more often prescribed flecainide than those in the sedentary group (adjusted HR=3.14, 95% CI 2.17 to 4.54). CONCLUSIONS: This population based study supports the hypothesis that the risk of drug treated lone AF increases with declining resting heart rate in both sexes, and with increasing levels of self-reported physical activity in men.
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This results in a U-shaped relationship of physical activity and incident AF.
“This results in a U-shaped relationship of physical activity and incident AF. 214,898,902,905,906”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [902]
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- Authors
- Thelle, D. S., Selmer, R., Gjesdal, K., Sakshaug, S., Jugessur, A., Graff-Iversen, S., Tverdal, A., & Nystad, W.
- Affiliations
- Norwegian Institute of Public Health (NO)
- Oslo University Hospital (NO)
- Royal Children's Hospital (AU)
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
- Corresponding author
- Thelle, Dag S
- Venue
- Heart
- Publisher
- BMJ
- Published
- 2013-06-08
- Volume
- 99
- Issue
- 23
- Pages
- 1755-1760
- ISSN
- 1355-6037 (ISSN-L)
- 1468-201X
- OpenAlex
- W2104581384
- Cited by
- 116
- References
- 28
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 7 · 2023: 6 · 2022: 4 · 2021: 8 · 2020: 11 · 2019: 10 · 2018: 13 · 2017: 9 · 2016: 17 · 2015: 15 · 2014: 9 · 2013: 2
- FWCI
- 9.75
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- Heart (publishedVersion)
- PubMed (publishedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- lone atrial fibrillation, resting heart rate, leisure-time physical activity, sedentary behavior, flecainide, sotalol, middle-aged adults, sex differences, cardiovascular risk factors
- MeSH terms
- Adult, Anti-Arrhythmia Agents, Atrial Fibrillation, Female, Flecainide, Heart Rate, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Sotalol, Exercise, Proportional Hazards Models, Early Diagnosis
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