Exercise attenuates higher AF risk in patients with atrial enlargement, finds a study

This prospective study followed 2479 participants (52.4% female), free from known cardiac pathology, for median of 20.2 years. Participants were followed up for hospital-diagnosed AF, confirmed by electrocardiography, from 1994-95 through 2016. At baseline, LA size was evaluated by anteroposterior LA diameter, and PA was self-reported by questionnaire.

Results:

Researchers observed a U-shaped relationship between PA and AF, and moderately active had 32% lower AF risk than inactive (HRadjusted 0.68, 95% CI 0.50 to 0.93). Participants with LA enlargement had 38% higher AF risk compared with participants with normal LA size (HRadjusted 1.38, 95% CI 1.12 to 1.69). However, the increased AF risk with LA enlargement was attenuated by PA; compared with inactive participants with LA enlargement, the AF risk was 45% lower among active with LA enlargement (HRadjusted 0.55, 95% CI 0.39 to 0.79). AF risk inactive participants with LA enlargement did not differ from active with normal LA size. These patterns were observed in both men and women, and in participants over/under 65 years.

Thus, Moderate PA was associated with reduced AF risk, and PA attenuated the increased risk of AF with LA enlargement in both men and women and all age groups.

Reference:

Associations between physical activity left atrial size and incident atrial fibrillation: the Tromsø Study 1994-2016 by Kim Arne Heitmann et al. published in the Open Heart.

https://pubmed.ncbi.nlm.nih.gov/35074937/