@article{b86f881973e643b48d21ab0eeac0db35,
title = "High fitness might be associated with the development of new-onset atrial fibrillation in obese non-athletic adults",
abstract = "Background: Data on the association between AF and fitness are conflicting. Objectives: The aim of this analysis was to investigate the association between fitness, obesity and incidence of atrial fibrillation (AF) among apparently healthy non-athlete adults. Methods: We investigated 20 410 self-referred subjects who were annually screened in a tertiary medical centre. All subjects were free of AF and completed maximal exercise stress test according to the Bruce protocol at baseline. Fitness was categorised into age- and sex-specific quintiles (Q) according to the treadmill time. Subjects were categorised to low (Q1-Q2) and high fitness (Q3-5) groups. The primary end point was new-onset AF during follow-up. Results: Mean age was 48 ± 10 years and 72\% were men. A total of 463 (2.3\%) events occurred during an average follow-up of 8 ± 5 years corresponding to an AF event rate of 0.3\% per person year. Univariate and multivariate models showed that AF risk was similar in both fitness groups. However, AF event rate was 0.55\% per person year among high fitness obese subjects, compared with 0.31\% for low fitness obese subjects (P <.01). Subgroup interaction analysis showed that AF risk is obesity-dependent, such that in the obese group (≥30 kg/m2) high fitness was independently associated with a significant 79\% increased AF risk (95\% CI 1.15-2.78; P =.01), whereas among non-obese subjects the rate of events was similar between both fitness groups (P for interaction = (.02)). Conclusions: Our findings suggest that high fitness might be associated with increased AF risk among obese subjects.",
author = "Arwa Younis and Anat Berkovitch and Shlomo Segev and Shaye Kivity and Robert Klempfner and Arsalan Abu-Much and Ilan Goldenberg and Elad Maor",
note = "Publisher Copyright: {\textcopyright} 2020 John Wiley \& Sons Ltd",
year = "2020",
month = dec,
doi = "10.1111/ijcp.13638",
language = "אנגלית",
volume = "74",
journal = "International Journal of Clinical Practice",
issn = "1368-5031",
publisher = "John Wiley and Sons Ltd",
number = "12",
}