Association of physical activity and risk of atrial fibrillation in heart failure with preserved ejection fraction.

BACKGROUND AND AIMS: Physical activity (PA) could modify the risk of atrial fibrillation (AF) in the general population and mortality in heart failure patients with preserved ejection fraction (HFpEF). HFpEF patients are frequently concomitant with AF, but whether PA could modify the risk of AF in HFpEF patients remains undiscovered.

METHOD AND RESULTS: We performed a post hoc analysis of the TOPCAT trial. Patients without AF at baseline and with data on PA (n = 652) were included. The association between PA and risk of AF occurrence was explored using the Cox proportional hazard model. During a median follow-up of 2.84 years, 9.4% of the studied patients (n = 60) had an occurrence of AF. When PA was analyzed as a continuous variable, every ten-fold increase of PA was associated with a 42.8% risk reduction of AF occurrence (hazard ratio [HR] 0.572, 95% CI 0.357-0.916, p = 0.020). When HFpEF patients were divided into three tertile groups according to PA levels, patients in the second tertile (HR 0.507, 95% CI 0.272-0.946, p = 0.033) and the third tertile (HR 0.487, 95% CI 0.261-0.908, p = 0.024) had significantly lower risks of AF occurrence when compared to those in the first tertile.

CONCLUSIONS: Our current results suggest that a higher PA level associates with a lower risk of AF in HFpEF patients.

CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov. Unique identifier: NCT00094302.