| Title: | Moderate-to-Vigorous Intensity Physical Activity and Risk of Incident Atrial Fibrillation in Atrial Cardiomyopathy |
| Journal: | JACC Advances |
| Published: | 14 Jul 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42663368/ |
| DOI: | https://doi.org/10.1016/j.jacadv.2026.102999 |
| URL: | http://dx.doi.org/10.1016/j.jacadv.2026.102999 |
Publication 21389
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Abstract
BACKGROUND: Current guidelines recommend physical activity for atrial fibrillation (AF) prevention, yet its role in individuals with atrial cardiomyopathy (AtCM) remains unclear.</p>
OBJECTIVES: We investigated the association between accelerometer-measured moderate-to-vigorous intensity physical activity (MVPA) and incident AF according to AtCM status.</p>
METHODS: Among 10,003 UK Biobank participants, AtCM was identified via multimodal approach integrating cardiovascular magnetic resonance imaging and 12-lead electrocardiography. Multivariable adjusted Cox proportional hazards models assessed the association between 7-day accelerometer-measured MVPA and incident AF. An interaction term evaluated substrate-specific associations.</p>
RESULTS: AtCM was identified in 4.5% of participants. Over a median follow-up of 3.2 years, AtCM was associated with an increased risk of AF (HR: 3.01; 95% CI: 1.69 to 5.37). AtCM status significantly modified the MVPA-AF association (P for interaction = 0.029). Without AtCM, MVPA showed marginal risk reduction (HR per 10-minute increase: 0.94; 95% CI: 0.87-1.01). Conversely, with AtCM, MVPA was strongly associated with a lower AF risk (HR per 10-minute increase: 0.76; 95% CI: 0.62-0.93). The absolute risk reduction was 2.82 AF events per 1,000 person-years for every 10-minute increase in MVPA in the AtCM group, significantly greater than without AtCM (difference: -2.66; 95% CI: -4.32 to -0.73; P = 0.011). Findings remained robust across comprehensive sensitivity analyses.</p>
CONCLUSIONS: 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.</p>
8 Authors
- Min Kim
- Pil-Sung Yang
- Ho-Gi Chung
- Juntae Kim
- Daehoon Kim
- Han-Joon Bae
- Moon-Hyun Kim
- Boyoung Joung
1 Application
| Application ID | Title |
|---|---|
| 77793 | The causal inference study to determine the association of genetically predicted biological, behavioral, ethnic factors with risk of atrial fibrillation and its associated complications. |
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