The role of exercise in atrial fibrillation prevention and promotion: Finding optimal ranges for health

The cardiovascular benefits of regular exercise have been well described, including a significant reduction in cardiovascular morbidity and mortality for those meeting recommended guidelines. Yet the impact of physical activity on the incidence of atrial fibrillation (AF) has been less clear. This review seeks to define the optimal dose and duration for the prevention and treatment of AF. In doing so, we review the evidence that supports a decline in AF risk for those who achieve a weekly physical activity dose slightly above the current recommended guidelines. Furthermore, we identify the reduced AF incidence in those individuals who attain a cardiorespiratory fitness of 8 METs (metabolic equivalents of task) or more during maximal exercise testing. Finally, we review the evidence that shows an excess of AF among regular participants of endurance exercise.