Physical Activity, Height, and Left Atrial Size Are Independent Risk Factors for Lone Atrial Fibrillation in Middle-aged Healthy Individuals

Aims: The aetiology of atrial fibrillation (AF) remains unknown in some patients. The aim of the study was to identify new risk factors for developing lone AF (LAF).

Methods And Results: A series of 107 consecutive patients younger than 65, seen in the emergency room for an episode of LAF of <48 h duration were included in the study. A group of 107 healthy volunteers matched for age and sex were recruited as controls. All subjects answered a validated questionnaire concerning leisure and occupational activities performed throughout their lifetimes to estimate accumulated hours of physical effort, classified in four levels of intensity. Demographic and echocardiographic measurements were also recorded. There were 69% of males and mean age was 48 +/- 11 years. AF was paroxysmal in 57% and persistent in the remaining 43%. Patients with AF performed more hours of both moderate and heavy intensity physical activity. They also were taller, and had a larger left atria, ventricle, and body surface area. At the multivariable analysis, only moderate and heavy physical activity, height, and anteroposterior atrial diameter were independently associated with LAF.

Conclusions: Accumulated lifetime physical activity, height, and left atrial size are risk factors for LAF in healthy middle-aged individuals.