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Exploring the Association Between Physical Activity and Atrial Fibrillation: A Systematic Review of Meta-Analyses

Background: Numerous studies suggestintensiveand prolonged exerciseis a risk factor for atrial fibrillation (AF); many other studies have shown that regular exercise can protectagainst AF in the general population. Meta-analyses of these studies have produced conflicting results. Thus, we performed a systematic review of meta-analyses to understand better the evidence base linking exercise and AF. Methods: We conducted a systematic review of meta-analyses that evaluated the association between physical activity (PA) and AF. A search of MEDLINE, Scopus, and Google Scholar was performed. TheAssessing Methodological Quality of Systematic Reviews 2 (AMSTAR 2) measurement tool was used to evaluate the methodological quality of the included reviews. Results:A total of twelve meta-analyses met the inclusion criteria. Five meta-analyses reported consistent evidence that the risk of AF was increased among athletes compared to non-athletes.The increased risk of AFranged from OR 1.64(1.10-2.43) to OR 5.3(3.6-7.9). The results were less consistent among studies of different degrees of PA as three reviews suggest that PA was associated with a reduction in AF, but most studies reported no difference in AF risk. Subgroup analyses suggest that individuals younger than 54-60 years and men were more likely to develop AF with PA. Conclusion: PA has a dose-dependent J-shape effect on AF risk, with increased risk at very low and very high levels of PA. This effect seems to be gender-specific and more pronounced in younger males.

Credits: Andreas Müssigbrodt, Alireza Sepehri Shamloo, John Mandrola, Jawdat Abdulla, Hakeem Ayinde, Cristian Ricci, Natale Daniele Brunetti, Chun Shing Kwok, Sanghamitra Mohanty, Andrea Natale, Jedrzej Kosiuk, Tiago Luiz Luz Leiria, Simon Kircher, Nikolaos Dagres, Sergio Richter, Arash Arya1, Andreas Bollmann, Gerhard Hindricks, and Michael Doering

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Introduction to AFib
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