Incidence of atrial fibrillation is associated with age and gender in subjects practicing physical exercise: A meta-analysis and meta-regression analysis

Brunetti, Natale Daniele; Santoro, Francesco; Correale, Michele; Conte, G

doi:10.1016/j.ijcard.2016.07.133

Cited by 17 publications

(14 citation statements)

References 20 publications

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“…In this meta-analysis, high heterogenicity was detected in trials comparing dexmedetomidine with placebo (I 2 = 75%), midazolam (I 2 = 57%), and propofol (or pentobarbital) (I 2 = 58%), respectively. Subgroup analysis is an effective method to solve large heterogenicity among studies (99). We suggested some possible risk factors associated with overt heterogenicity including the year of publication, study methods, the country of authors, the time of drug administration, the type of surgery, routes of drug administration, the bias risk of the study, and the range of patients' age.…”

Section: Discussionmentioning

confidence: 99%

“…Meta-regression was used to identify heterogenicity sources. If the P -value of meta-regression was <0.05 through analyzing one risk factor, the subgroup analysis was performed based on this risk factor ( 99 , 100 ). However, in this meta-analysis, all P -values of meta-regression were more than 0.05 through analyzing all possible risk factors in the placebo and midazolam groups.…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Dexmedetomidine on Emergence Agitation or Delirium in Children After Anesthesia—A Systematic Review and Meta-Analysis of Clinical Studies

et al. 2020

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Background: We conducted this systematic review and meta-analysis to investigate the clinical effect of dexmedetomidine in preventing pediatric emergence agitation (EA) or delirium (ED) following anesthesia compared with placebo or other sedatives. Methods: The databases of Pubmed, Embase, and Cochrane Library were searched until 8th January 2020. Inclusion criteria were participants with age<18 years and studies of comparison between dexmedetomidine and placebo or other sedatives. Exclusion criteria included adult studies; duplicate publications; management with dexmedetomidine alone; review or meta-analysis; basic research; article published as abstract, letter, case report, editorial, note, method, or protocol; and article presented in non-English language. Results: Fifty-eight randomized controlled trials (RCTs) and five case-control trials (CCTs) including 7,714 patients were included. The results showed that dexmedetomidine significantly decreased the incidence of post-anesthesia EA or ED compared with placebo [OR = 0.22, 95% CI: (0.16, 0.32), I 2 = 75, P < 0.00001], midazolam [OR = 0.36, 95% CI: (0.21, 0.63), I 2 = 57, P = 0.0003], and opioids [OR = 0.55, 95% CI: (0.33, 0.91), I 2 = 0, P = 0.02], whereas the significant difference was not exhibited compared with propofol (or pentobarbital) [OR = 0.56, 95% CI: (0.15, 2.14), I 2 = 58, P = 0.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Effect of Dexmedetomidine on Emergence Agitation or Delirium in Children After Anesthesia—A Systematic Review and Meta-Analysis of Clinical Studies

et al. 2020

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“…In a meta-analysis by Brunetti et al that included all levels of physical activity [ 22 ], age was found to modulate the relationship between physical exercise and AF. Specifically, there was an increased risk of AF in studies enrolling subjects <54 years (OR 5.30 [3.48–8.20]).…”

Section: Discussionmentioning

confidence: 99%

Age modifies the risk of atrial fibrillation among athletes: A systematic literature review and meta-analysis

Ayinde

Schweizer

Crabb

et al. 2018

IJC Heart & Vasculature

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BackgroundThe relationship between competitive sports and atrial fibrillation (AF) is controversial. We aimed to systematically evaluate and summarize all published observational data on the association between competitive sports and AF.Methods and resultsWe searched PubMed, EMBASE, Scopus and SportDiskus for all observational studies that assessed the risk of AF among athletes involved in competitive sports. Data were extracted and pooled odds ratios (OR) were calculated using random effects models. Six cohort studies and 2 case-control studies with a total of 9113 subjects were included in our meta-analysis. Pooled analyses showed an increased risk of incident and prevalent AF among athletes compared to the general population (OR = 1.64 [95% confidence interval (CI): 1.10–2.43]). Age-stratified analysis revealed an effect modification with age. Studies enrolling younger adults (<54 years) had an increased risk of AF among athletes compared to controls (OR = 1.96 [95% CI: 1.06–3.65]), but this association was not seen among older adults ≥54 years (OR = 1.41 [95% CI: 0.81–2.44], p = 0.23).ConclusionAthletes have an increased risk of AF compared to the general population. Age appears to modify the risk of AF in athletes.

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“…Speculatively, it seems plausible to propose that by simple closed loop mechanisms, the delay in the response of these conductions speeds to the changing heart rate contributes to the stability of intra-atrial and atrioventricular depolarization. Hence, the substantial sex differences in the PQ/RR hysteresis (with women changing their PQ intervals with a longer delay) together with the differences in PQ/RR slopes and in PQc intervals as well as the marginally shorter P wave durations might all be contributing to the reduced incidence of atrial fibrillation in pre-menopausal women compared to similarly aged men 29,30 . The hypothesis that heart rate changes might decrease intra-atrial depolarization stability seems also consistent with the observation that the risk of atrial fibrillation is increased in younger subjects practicing physical exercise 31 .…”

Section: Discussionmentioning

confidence: 99%

Physiologic heart rate dependency of the PQ interval and its sex differences

Toman

Hnatkova

Smetana

et al. 2020

Sci Rep

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on standard electrocardiogram (ecG) pQ interval is known to be moderately heart rate dependent, but no physiologic details of this dependency have been established. At the same time, pQ dynamics is a clear candidate for non-invasive assessment of atrial abnormalities including the risk of atrial fibrillation. We studied PQ heart rate dependency in 599 healthy subjects (aged 33.5 ± 9.3 years, 288 females) in whom drug-free daytime 12-lead ECG Holters were available. Of these, 752,517 ECG samples were selected (1256 ± 244 per subject) to measure PQ and QT intervals and P wave durations. For each measured ECG sample, 5-minute history of preceding cardiac cycles was also obtained. Although less rate dependent than the QT intervals (36 ± 19% of linear slopes), PQ intervals were found to be dependent on underlying cycle length in a highly curvilinear fashion with the dependency significantly more curved in females compared to males. The PQ interval also responded to the heart rate changes with a delay which was highly sex dependent (95% adaptation in females and males after 114.9 ± 81.1 vs 65.4 ± 64.3 seconds, respectively, p < 0.00001). P wave duration was even less rate dependent than the PQ interval (9 ± 10% of linear QT/RR slopes). Rate corrected P wave duration was marginally but significantly shorter in females than in males (106.8 ± 8.4 vs 110.2 ± 7.9 ms, p < 0.00001). In addition to establishing physiologic standards, the study suggests that the curvatures and adaptation delay of the PQ/cycle-length dependency should be included in future non-invasive studies of atrial depolarizations. The electrocardiographic (ECG) interval between the onset of the P wave and the onset of the QRS complex is frequently called the PR interval but should be more accurately termed the PQ interval. As well known, the duration of this interval represents the combination of the intra-atrial conduction and of the excitation delay within the atrioventricular node. Abnormalities of the PQ interval are associated not only with the atrioventricular node pathologies but also with intra-atrial anomalies. In addition to the diagnosis of atrioventricular conduction pathologies, monitoring of the PQ interval is therefore useful for the assessment and device programming of cardiac resynchronization therapy 1-3 as well as for clinical follow-up of heart failure patients 4,5. Prolongation of the PQ interval was also found predicting adverse outcome in general population 6,7. More recently, a number of studies showed that PQ interval may be used as a risk indicator of subsequent development of atrial fibrillation or of its recurrence after ablation therapy 8-11. Similarly, risk of atrial fibrillation was reported to relate to the P wave duration 12,13. Similar to the ventricular conduction system, intra-atrial conduction is influenced by the autonomic nervous system 14. It is therefore not surprising that PQ interval duration also exhibits autonomically modulated changes and that the interval is heart rate dependent 15,16. Also not surprisingly, s...

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Incidence of atrial fibrillation is associated with age and gender in subjects practicing physical exercise: A meta-analysis and meta-regression analysis

Cited by 17 publications

References 20 publications

The Effect of Dexmedetomidine on Emergence Agitation or Delirium in Children After Anesthesia—A Systematic Review and Meta-Analysis of Clinical Studies

The Effect of Dexmedetomidine on Emergence Agitation or Delirium in Children After Anesthesia—A Systematic Review and Meta-Analysis of Clinical Studies

Age modifies the risk of atrial fibrillation among athletes: A systematic literature review and meta-analysis

Physiologic heart rate dependency of the PQ interval and its sex differences

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