exercise and AFIB

Posted on by Sameer Oza

As an electrophysiologist in Boulder, Colorado I get a lot of questions about how much exercise is recommended for patients with arrhythmias. Exercise is good for you but is more better? Anecdotal evidence has suggested that endurance exercise increases the risk of atrial fibrillation.

A recent study published in European Heart Journal addressed this issue. 402406 individuals (52.5% female) were followed over 2.8 million person-hours of follow up.

“Association between physical activity and risk of incident arrhythmias” PDF downloadDownload

Gist of article:

  • Exercise > 500 MET-min/week is associated with a reduced risk of AF
  • Exercise >2500 MET-min/week is associated with a higher risk of AFIB in men
Guidelines directed physical activity (5–1500 MET-min/wk) is associated with a reduction in incident atrial fibrillation from both males and females, with a largest effect for females. Similarly, physical activity is associated with a reduction in ventricular arrhythmias. However, we observed no association between physical activity and bradyarrhythmia risk.
Plot of incident atrial fibrillation risk against total physical activity (upper panel) and vigorous physical activity (lower panel) stratified by sex. The shaded area represents the 95% confidence bands. All models adjusted for age, body mass index, smoking, alcohol intake, hypertension, Type 2 diabetes, sleep apnoea, heart failure, valvular disease, and coronary artery disease.

Walking 4 miles per hour on flat surface is about 4 METS. Here is a graphic illustrating common exercises:

Image result for mets exercise