Atrial fibrillation and exercise in women: some answers given, some questions remain

Physical activity, resting heart rate, and atrial fibrillation: the Tromsø Study

“…Low RHR was a risk factor for AF. Our results support the hypothesis that there may be two contradictory pathophysiological mechanisms behind the association of physical activity with AF: 22 a protective effect of moderate physical activity via reduced cardiovascular risk and an increased risk of AF associated with more vigorous physical activity via cardiac adaptations and low RHR. Further research is recommended to clarify the association between physical activity and AF, preferably with objective measures of physical activity.…”

“…AF that occurs due to mechanisms related to exercise training, such as structural cardiac adaptations and lower RHR ('athlete's heart'), the present study aimed to include all diagnosed AF. As suggested in a recent review 22 and supported by the present study, the mechanisms explaining the relationship of physical activity with AF could involve two distinct pathways. 22 Moderate physical activity may reduce AF risk via improved cardiovascular risk factors.…”

“…As suggested in a recent review 22 and supported by the present study, the mechanisms explaining the relationship of physical activity with AF could involve two distinct pathways. 22 Moderate physical activity may reduce AF risk via improved cardiovascular risk factors. However, this beneficial effect of moderate physical activity on AF may be mitigated by years of endurance training, which generates structural and functional cardiac adaptations that increase the risk of AF, including lower RHR.…”

Differential Association of Exercise Intensity With Risk of Atrial Fibrillation in Men and Women: Evidence from a Meta‐Analysis

“…Four studies examined women‐only population, 6 trials included only men, and remaining studies had participants from both genders. Many researchers have questioned the validity of the gender‐specific influence of physical activity on AF citing the argument that in addition to the number of differences between the male and female heart with respect to AF, vigorous exercise probably covers a wide range of intensity and duration of PA, possibly differing between genders . However, data supporting gender‐specific correlation from studies that included both men and women being exposed to similar intensity of vigorous exercise challenge the above assumption.…”

Independent effect of physical activity and resting heart rate on the incidence of atrial fibrillation in the general population

“…These findings are consistent with previous studies that showed a higher risk of AF in high- or vigorous-activity 8 and high level-PA attenuated the benefit of moderate PA 3 . Several pathways have been suggested to explain the mechanism by which PA affects the risk of AF 13 . Moderate PA modulates cardiovascular risk factors and markers of inflammation 14,15 .…”