Korean J Intern Med.  2023 Nov;38(6):872-878. 10.3904/kjim.2023.075.

Exercise capacity and risk of incident atrial fibrillation in healthy adults

• Kim JY
• Cho SJ
• Kim J
• Chung TW
• Park SJ
• Park KM
• Kim JS
• On YK

• KMID: 2547645
• DOI: http://doi.org/10.3904/kjim.2023.075

Abstract

Background/Aims
Atrial fibrillation (AF) is a common arrhythmia and is associated with cardiovascular morbidity and mortality. It is important to identify and control the modifiable risk factors of AF. We aimed to examine the association of exercise capacity with the risk of incident AF within 3 years in healthy subjects.
Methods
We evaluated asymptomatic adults who had undergone more than two consecutive health checkups. We included subjects who exhibited normal sinus rhythm on the first health examination and who developed AF on the second or subsequent health examinations. Subjects who underwent cardiopulmonary exercise testing within 3 years before the diagnosis of AF were examined.
Results
The study population in the analyses included 428 cases (mean age 58.4 ± 7.6 yr, male 95.6%). There were significant differences in maximal systolic blood pressure (SBP; case 169.4 ± 24.2 vs. control 173.9 ± 22.3 mmHg), peak VO₂ (29.5 ± 5.4 vs. 30.4 ± 4.8 mL/kg per minute), and maximal metabolic equivalents (METs; 8.5 ± 1.6 vs. 8.7 ± 1.4) between the two groups. In the multivariable logistic models, adjusted odds ratios were 0.99 for maximal SBP (95% confidence interval [CI] 0.98–0.99), 0.97 for peak VO₂ (95% CI 0.95–0.99), and 0.91 for maximal METs (95% CI 0.83–0.98).
Conclusions
We demonstrated that poorer exercise capacity was associated with the development of AF in a healthy population. A prospective, systematic trial is necessary to confirm that appropriate exercise training will be beneficial in preventing the development of AF in such patients.

Keyword

Atrial fibrillation; Cardiopulmonary exercise testing; Exercise capacity