Exercise and Atrial Fibrillation: Current Evidence, Knowledge Gaps, and Future Directions

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, contributing to significant morbidity and mortality worldwide. The relationship between physical exercise and AF is complex, with studies showing both beneficial and potentially adverse effects. Moreover, evidence suggests a U...

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Main Authors: Hoang Nhat Pham, Mahmoud H. Abdelnabi, Ramzi Ibrahim, Enkhtsogt Sainbayar, Hong Hieu Truong, Eiad Habib, Girish Pathangey, George Bcharah, Amitoj Singh, Reza Arsanjani, Anwar A. Chahal, Dan Sorajja
Format: Article
Language:English
Published: IMR Press 2025-07-01
Series:Reviews in Cardiovascular Medicine
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Online Access:https://www.imrpress.com/journal/RCM/26/7/10.31083/RCM39200
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author Hoang Nhat Pham
Mahmoud H. Abdelnabi
Ramzi Ibrahim
Enkhtsogt Sainbayar
Hong Hieu Truong
Eiad Habib
Girish Pathangey
George Bcharah
Amitoj Singh
Reza Arsanjani
Anwar A. Chahal
Dan Sorajja
author_facet Hoang Nhat Pham
Mahmoud H. Abdelnabi
Ramzi Ibrahim
Enkhtsogt Sainbayar
Hong Hieu Truong
Eiad Habib
Girish Pathangey
George Bcharah
Amitoj Singh
Reza Arsanjani
Anwar A. Chahal
Dan Sorajja
author_sort Hoang Nhat Pham
collection DOAJ
description Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, contributing to significant morbidity and mortality worldwide. The relationship between physical exercise and AF is complex, with studies showing both beneficial and potentially adverse effects. Moreover, evidence suggests a U-shaped association between exercise intensity and AF risk. Moderate exercise has been shown to reduce AF burden by improving cardiovascular risk factors, enhancing autonomic regulation, and mitigating atrial fibrosis. In contrast, excessively high-intensity endurance exercise may increase AF risk, particularly in young athletes, due to atrial stretching, dilation, fibrosis, autonomic imbalances, and heightened inflammation. The current guidelines emphasize exercise as a core lifestyle intervention for AF management, recommending moderate-intensity aerobic activity for optimal outcomes. This review examines the current evidence on the effects of exercise on AF, identifies knowledge gaps, and proposes potential future research directions.
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institution Kabale University
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publishDate 2025-07-01
publisher IMR Press
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series Reviews in Cardiovascular Medicine
spelling doaj-art-cd4e31bad98e4fb5be30b804dd30c1302025-08-20T03:44:28ZengIMR PressReviews in Cardiovascular Medicine1530-65502025-07-012673920010.31083/RCM39200S1530-6550(25)01891-5Exercise and Atrial Fibrillation: Current Evidence, Knowledge Gaps, and Future DirectionsHoang Nhat Pham0Mahmoud H. Abdelnabi1Ramzi Ibrahim2Enkhtsogt Sainbayar3Hong Hieu Truong4Eiad Habib5Girish Pathangey6George Bcharah7Amitoj Singh8Reza Arsanjani9Anwar A. Chahal10Dan Sorajja11Department of Medicine, University of Arizona, Tucson, AZ 85721, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Medicine, University of Arizona, Tucson, AZ 85721, USADepartment of Internal Medicine, Ascension Saint Francis, Evanston, IL 60202, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USAMayo Clinic Alix School of Medicine, Phoenix, AZ 85054, USADepartment of Cardiology, Sarver Heart Center, University of Arizona, Tucson, AZ 85721, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55901, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USAAtrial fibrillation (AF) is the most common sustained cardiac arrhythmia, contributing to significant morbidity and mortality worldwide. The relationship between physical exercise and AF is complex, with studies showing both beneficial and potentially adverse effects. Moreover, evidence suggests a U-shaped association between exercise intensity and AF risk. Moderate exercise has been shown to reduce AF burden by improving cardiovascular risk factors, enhancing autonomic regulation, and mitigating atrial fibrosis. In contrast, excessively high-intensity endurance exercise may increase AF risk, particularly in young athletes, due to atrial stretching, dilation, fibrosis, autonomic imbalances, and heightened inflammation. The current guidelines emphasize exercise as a core lifestyle intervention for AF management, recommending moderate-intensity aerobic activity for optimal outcomes. This review examines the current evidence on the effects of exercise on AF, identifies knowledge gaps, and proposes potential future research directions.https://www.imrpress.com/journal/RCM/26/7/10.31083/RCM39200atrial fibrillation (af)exercise intensitymoderate-intensity exerciseendurance exerciseaf burdencardiorespiratory fitness (crf)cardiovascular risk
spellingShingle Hoang Nhat Pham
Mahmoud H. Abdelnabi
Ramzi Ibrahim
Enkhtsogt Sainbayar
Hong Hieu Truong
Eiad Habib
Girish Pathangey
George Bcharah
Amitoj Singh
Reza Arsanjani
Anwar A. Chahal
Dan Sorajja
Exercise and Atrial Fibrillation: Current Evidence, Knowledge Gaps, and Future Directions
Reviews in Cardiovascular Medicine
atrial fibrillation (af)
exercise intensity
moderate-intensity exercise
endurance exercise
af burden
cardiorespiratory fitness (crf)
cardiovascular risk
title Exercise and Atrial Fibrillation: Current Evidence, Knowledge Gaps, and Future Directions
title_full Exercise and Atrial Fibrillation: Current Evidence, Knowledge Gaps, and Future Directions
title_fullStr Exercise and Atrial Fibrillation: Current Evidence, Knowledge Gaps, and Future Directions
title_full_unstemmed Exercise and Atrial Fibrillation: Current Evidence, Knowledge Gaps, and Future Directions
title_short Exercise and Atrial Fibrillation: Current Evidence, Knowledge Gaps, and Future Directions
title_sort exercise and atrial fibrillation current evidence knowledge gaps and future directions
topic atrial fibrillation (af)
exercise intensity
moderate-intensity exercise
endurance exercise
af burden
cardiorespiratory fitness (crf)
cardiovascular risk
url https://www.imrpress.com/journal/RCM/26/7/10.31083/RCM39200
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