Arrhythmias & electrophysiologyCohort study
Moderate-to-Vigorous Intensity Physical Activity and Risk of Incident Atrial Fibrillation in Atrial Cardiomyopathy
- Cohort study (UK Biobank)
- accelerometer-measured MVPA
- multivariable adjusted Cox proportional hazards models
Authors' conclusion
MVPA demonstrated a robust inverse association with incident AF risk, particularly in individuals with AtCM. Identifying subclinical atrial substrate may guide targeted physical activity recommendations, suggesting MVPA as a potent lifestyle intervention to attenuate the transition from subclinical remodeling to overt clinical arrhythmia.
Study context
- Population
- UK Biobank participants with cardiovascular magnetic resonance imaging and 12-lead electrocardiography
- Participants
- 10,003 UK Biobank participants
- Exposure
- Association between accelerometer-measured MVPA and incident atrial fibrillation (AF) according to atrial cardiomyopathy (AtCM) status
Main finding
As reported in the abstract
Prevalence of AtCM
AtCM identified in
4.5% of participants
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Incident AF, AtCM vs without AtCM · median follow-up of 3.2 years · increased risk of AF with AtCM | 3.01 (1.69–5.37) | ||
| Incident AF per 10-minute increase in MVPA, without AtCM · without AtCM; marginal risk reduction | 0.94 (0.87–1.01) | ||
| Incident AF per 10-minute increase in MVPA, with AtCM · with AtCM; lower AF risk | 0.76 (0.62–0.93) | ||
| 0.20.5125Hazard ratio (log scale) |
| Outcome | AtCM | Without AtCM | difference (95% CI) | P value | |
|---|---|---|---|---|---|
| Absolute risk reduction in AF per 10-minute increase in MVPA | absolute risk reduction 2.82 AF events per 1,000 person-years | Not reported in the abstract | −2.66 (−4.32 to −0.73) | P = 0.011 | |
| −6−4−202Difference (linear scale) |
- Absolute risk reduction in AF per 10-minute increase in MVPA: absolute risk reduction significantly greater in the AtCM group
Effect modification of MVPA-AF association by AtCM status
- AtCM status significantly modified the MVPA-AF association
- P for interaction = 0.029
Sensitivity analyses
- Findings remained robust across comprehensive sensitivity analyses
Original publication
Moderate-to-Vigorous Intensity Physical Activity and Risk of Incident Atrial Fibrillation in Atrial Cardiomyopathy. JACC Adv. Published 14 July 2026. doi:10.1016/j.jacadv.2026.102999
Summarised from the published abstract; every number is checked against it