A systematic evaluation of the available evidence suggests similarities as well as important differences in the risk factors for incidence of AF as compared with other cardiovascular diseases , which has implication s for the primary prevention strategies for atrial fibrillation
Established primary prevention strategies of cardiovascular diseases are based on underst and ing of risk factors , but whether the same risk factors are associated with  atrial fibrillation ( AF )  remains unclear .
Physical Activity and Incidence of Atrial Fibrillation in Older Adults: The Cardiovascular Health Study
Background — Vigorous exertion and endurance training have been reported to increase  atrial fibrillation ( AF ) .  Associations of habitual light or moderate activity with AF incidence have not been evaluated . Methods and Results — We prospect ively investigated associations of leisure-time activity , exercise intensity , and walking habits , assessed at baseline and up date d during follow-up visits , with incident AF , diagnosed by annual 12-lead ECGs and hospital discharge records , from 1989 to 2001 among 5446 adults ≥65 years of age in the Cardiovascular Health Study . During 47 280 person-years of follow-up , 1061 new AF cases occurred ( incidence 22.4/1000 person-years ) . In multivariable-adjusted analyses , leisure-time activity was associated with lower AF incidence in a grade d manner , with 25 % ( hazard ratio [ HR ] 0.75 , 95 % confidence interval [ CI ] 0.61 to 0.90 ) , 22 % ( HR 0.78 , 95 % CI 0.65 to 0.95 ) , and 36 % ( HR 0.64 , 95 % CI 0.52 to 0.79 ) lower risk in quintiles 3 , 4 , and 5 versus quintile 1 ( P for trend < 0.001 ) . Exercise intensity had a U-shaped relationship with AF ( quadratic P=0.02 ) : Versus no exercise , AF incidence was lower with moderate-intensity exercise ( HR 0.72 , 95 % CI 0.58 to 0.89 ) but not with high-intensity exercise ( HR 0.87 , 95 % CI 0.64 to 1.19 ) . Walking distance and pace were each associated with lower AF risk in a grade d manner ( P for trend < 0.001 ) ; when we assessed the combined effects of distance and pace , individuals in quartiles 2 , 3 , and 4 had 25 % ( HR 0.75 , 95 % CI 0.56 to 0.99 ) , 32 % ( HR 0.68 , 95 % CI 0.50 to 0.92 ) , and 44 % ( HR 0.56 , 95 % CI 0.38 to 0.82 ) lower AF incidence than individuals in quartile 1 . Findings appeared unrelated to confounding by comorbidity or indication . After evaluation of cut points of moderate leisure-time activity ( ≈600 kcal/week ) , walking distance ( 12 blocks per week ) , and pace ( 2 mph ) , 26 % of all new AF cases ( 95 % CI 7 % to 43 % ) appeared attributable to absence of these activities . Conclusions — Light to moderate physical activities , particularly leisure-time activity and walking , are associated with significantly lower AF incidence in older adults
A systematic evaluation of the available evidence suggests similarities as well as important differences in the risk factors for incidence of AF as compared with other cardiovascular diseases , which has implication s for the primary prevention strategies for atrial fibrillation
Established primary prevention strategies of cardiovascular diseases are based on underst and ing of risk factors , but whether the same risk factors are associated with  atrial fibrillation ( AF )  remains unclear .