Physical Activity and Incidence of Atrial Fibrillation - Systematic Review and Meta-Analysis

Abstract Background: The relationship between exercise and atrial fibrillation (AF) is controversial. Objectives: To analyze the effects of physical activity on the incidence of atrial fibrillation using systematic review and meta-analysis. Methods: Systematic review and meta-analysis of studies that relate physical exercise and atrial fibrillation. The following databases were searched: PubMed, BVS Saúde and Cochrane. The following descriptors were used: "atrial fibrillation", "exercise", "physical activity" and "exercise therapy". All prospective, retrospective, cross-sectional and cohort studies were investigated. All statistical analyzes were provided using Review Manager 5.3 to provide the mean difference (MD) and relative risk (RR) ratio with 95% confidence intervals (95% CI). The statistical method of heterogeneity index was used to assess heterogeneity. Level of significance was 5%. Results: Combined analysis of 11 studies totaling 276,323 participants aged between 12 and 90 years did not suggest a significant increase in AF in individuals submitted to physical exercise (RR = 0.914, 95% CI = 0.833-1.003, heterogeneity: p < 0.001). Conclusions: Physical exercise, lato sensu, without stratification by intensity, sex or age does not seem to be associated with an increase of atrial fibrillation.

背景：运动与心房颤动（atrial fibrillation, AF）的关联尚存争议。研究目的：通过系统评价与荟萃分析，探讨体育运动对心房颤动发病风险的影响。研究方法：本研究针对运动与心房颤动的关联研究开展系统评价及荟萃分析。检索数据库包括PubMed、BVS Saúde及Cochrane图书馆。检索使用的关键词为：“atrial fibrillation”、“exercise”、“physical activity”及“exercise therapy”。纳入所有前瞻性、回顾性、横断面及队列研究。所有统计分析均采用Review Manager 5.3软件完成，计算均数差（mean difference, MD）与相对危险度（relative risk, RR），并给出95%置信区间（95% confidence intervals, 95% CI）。采用异质性指数统计方法评估研究间异质性，检验水准设定为5%。研究结果：对11项共计276323名年龄介于12至90岁参与者的研究进行合并分析后显示，接受体育运动干预的个体未出现心房颤动发病风险的显著升高（RR=0.914，95%CI=0.833~1.003，异质性检验：p<0.001）。研究结论：广义而言，未按运动强度、性别或年龄进行分层的体育运动，似乎与心房颤动发病风险升高并无关联。