The risk of atrial fibrillation amongst adults who perform vigorous exercise

Abstract

Overview of Topic: Physical activity is a holistic therapy recommended by health care professionals to decrease the risk of cardiovascular disease. However, various studies have shown an increased risk of atrial fibrillation amongst individuals who perform vigorous exercise. One of the main vital roles in nursing is health promotion and this is not possible without evidence based research. Thus the purpose of this dissertation is to investigate the relationship between vigorous exercise and the risk of atrial fibrillation by means of literature appraisal. The Research Question: Does vigorous exercise increase the risk of atrial fibrillation among adults? The PEO elements: Population Adults Exposure Vigorous Exercise Outcome Increased risk of Atrial Fibrillation The method: An extensive literature search encompassing multiple sources and carried out between January 2017 and September 2017 was implemented. Inclusion and Exclusion Criteria: The inclusion criteria comprised peer-reviewed English scientific journals. Males and females aged between 18 and 80 years old, who performed any type of vigorous exercise, were included. Any studies reporting any type of cardiac arrhythmias and eliminating atrial fibrillation were excluded. Articles that only assessed low or moderate physical activity and those studies that did not eliminate individuals with known heart disease were also excluded. To retrieve the most recent literature, publication date was filtered between 2012 to 2017. The Search: The search resulted in 13 studies consisting of four systematic reviews with meta-analysis, seven cohort studies and two case-control studies. Methods of Appraisal: The final 13 studies were then systematically appraised using the CASP tools, the Joanna Briggs Institute critical appraisal tools and the Centre for Evidence Based Medicine tools Results and conclusion of the study: Strong evidence supports the hypothesis: individuals who perform vigorous exercise are at an increased risk of atrial fibrillation. Conflicting evidence was found in two meta-analysis in which vigorous exercise in females was related with a lower risk of atrial fibrillation. Implications and Recommendations: Further studies regarding the borderline perimeters for exercise in sex stratified manner to prevent atrial fibrillation besides excluding the benefits of physical activity should be analysed. Moreover, all individuals who participate in vigorous exercise should be screened regularly.