title: Resting heart rate and physical activity as risk factors for lone atrial fibrillation: a prospective study of 309,540 men and women.
abstract: OBJECTIVE
  To study the impact of resting heart rate and leisure time physical activity at middle age on long term risk of drug treated lone atrial fibrillation (AF).
  
  
  METHODS
  Longitudinal cohort study of 309 540 Norwegian men and women aged 40-45 years examined during 1985-1999 followed from 2005 through 2009.
  
  
  METHODS
  Data from a national health screening programme were linked to the Norwegian Prescription Database (NorPD).
  
  
  METHODS
  The cohort comprised 162 078 women and 147 462 men; 575 (0.4%) men and 288 women (0.2%) received flecainide and 568 men and 256 women sotalol and were defined as patients with AF.
  
  
  METHODS
  No interventions.
  
  
  METHODS
  The outcome was lone fibrillation defined by having at least one prescription of flecainide or sotalol registered in NorPD between 2005 and 2009. Cox proportional hazard regression models were used to assess time to first prescription.
  
  
  RESULTS
  The risk for being prescribed these drugs increased with decreasing baseline resting heart. Adjusted hazard ratio (HR) per 10 beats/min decrease in resting heart rate for flecainide prescription was 1.26 in men (95% CI 1.17 to 1.35) and 1.15 (95% CI 1.05 to 1.27) in women. Similar effects were seen for sotalol in men, but not in women. Men who reported intensive physical activity were more often prescribed flecainide than those in the sedentary group (adjusted HR=3.14, 95% CI 2.17 to 4.54).
  
  
  CONCLUSIONS
  This population based study supports the hypothesis that the risk of drug treated lone AF increases with declining resting heart rate in both sexes, and with increasing levels of self-reported physical activity in men.
authors.affiliation: Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, , Oslo, Norway.
authors.forename: Dag S
authors.initials: DS
authors.lastname: Thelle
authors.forename: Randi
authors.initials: R
authors.lastname: Selmer
authors.forename: Knut
authors.initials: K
authors.lastname: Gjesdal
authors.forename: Solveig
authors.initials: S
authors.lastname: Sakshaug
authors.forename: Astanand
authors.initials: A
authors.lastname: Jugessur
authors.forename: Sidsel
authors.initials: S
authors.lastname: Graff-Iversen
authors.forename: Aage
authors.initials: A
authors.lastname: Tverdal
authors.forename: Wenche
authors.initials: W
authors.lastname: Nystad
mesh_terms: D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D042241:Early Diagnosis; D015444:Exercise / Q000502:physiology*; D005260:Female; D005424:Flecainide / Q000627:therapeutic use; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013015:Sotalol / Q000627:therapeutic use
chemical_list: D000889:Anti-Arrhythmia Agents; D013015:Sotalol; D005424:Flecainide