title: Differential Association of Exercise Intensity With Risk of Atrial Fibrillation in Men and Women: Evidence from a Meta-Analysis.
abstract: Despite widespread interest and extensive research, the association between different levels of physical activity (PA) and risk of atrial fibrillation (AF) is still not clearly defined. Therefore, we systematically evaluated and summarized the evidences regarding association of different intensity of PA with the risk of AF in this meta-analysis.
  
  
  
  An extensive literature search was performed on databases for studies showing association of exercise with AF risk. Twenty-two studies were identified that included 656,750 subjects. Meta-analytic estimates were derived using random-effects models and pooled odds ratio estimates were obtained. Potential sources of heterogeneity were examined in sensitivity analyses, and publication biases were estimated. Pooled analysis of 7 studies with 93,995 participants reported high risk of incident AF with sedentary lifestyle (pooled OR 2.47 [95% CI 1.25-3.7], P = 0.005). In 3 trials, 149,048 women involved in moderate PA were 8.6% less likely to develop AF compared to women with sedentary life (OR 0.91 [95% CI 0.78-0.97], P = 0.002). Women performing intense exercise were found to have 28% lower risk of AF (OR 0.72 [95% CI 0.57-0.88], P < 0.001). The overall pooled estimate indicated a protective impact of moderate PA in men (pooled OR 0.8133 [95% CI 0.26-1.004], P = 0.06) whereas vigorous PA was associated with a significantly increased AF risk (pooled OR 3.30 [1.97-4.63], P = 0.0002).
  
  
  
  Sedentary lifestyle significantly increases and moderate amount of physical activity reduces the risk of AF in both men and women. However, intense exercise has a gender-specific association with AF risk.
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
authors.forename: Sanghamitra
authors.initials: S
authors.lastname: Mohanty
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
authors.forename: Prasant
authors.initials: P
authors.lastname: Mohanty
authors.affiliation: Texas Cardiac Arrhythmia Research Foundation, Austin, Texas.
authors.forename: Megumi
authors.initials: M
authors.lastname: Tamaki
authors.affiliation: Department of Natural Science, University of Texas, Austin, Texas.
authors.forename: Veronica
authors.initials: V
authors.lastname: Natale
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.|University of Milan, Milan, Italy.
authors.forename: Carola
authors.initials: C
authors.lastname: Gianni
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
authors.forename: Chintan
authors.initials: C
authors.lastname: Trivedi
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.|Department of Cardiology, Gülhane Military Academy of Medicine, Ankara, Turkey.
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Gokoglan
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.|Albert Einstein College of Medicine, Montefiore Hospital, Bronx, New York.
authors.forename: Luigi
authors.initials: L
authors.lastname: DI Biase
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas. dr.natale@gmail.com.|California Pacific Medical Center, San Francisco, California, USA. dr.natale@gmail.com.|Interventional Electrophysiology, Scripps Clinic, San Diego, California, USA. dr.natale@gmail.com.|Department of Internal Medicine, Dell Medical School, Austin, Texas, USA. dr.natale@gmail.com.|Division of Cardiology, Stanford University, Palo Alto, California, USA. dr.natale@gmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D015444:Exercise; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D057185:Sedentary Behavior; D012737:Sex Factors
keywords: atrial fibrillation; exercise intensity; gender; physical activity; sedentary