- Guideline-adherent exercise is shown in a large study to be associated with substantially lower risks of atrial fibrillation and stroke.
- A new generation of “smart” devices with diagnostic capabilities could open the door to low-cost, highly effective disease prevention programs.
Steven Lubitz, MD, MPH
What we found was that activity in accordance with guideline recommendations is indeed associated with substantially lower risks of both atrial fibrillation and stroke.
Division of Cardiology, Massachusetts General Hospital
BOSTON – Physical activity that conforms to medical and health association guidelines is associated with a lower risk of atrial fibrillation (Afib) and stroke, according to a study by researchers at Massachusetts General Hospital (MGH), who analyzed nearly 100,000 individuals equipped with wrist-worn accelerometers to measure their movement. The researchers’ findings suggest that data from wearables, including a new generation of devices with sensors that allow for Afib detection, could provide an opportunity for the public health community to promote moderate physical activity as an effective way to improve health outcomes. The study was published in the European Heart Journal. 
“Although some population-based studies have observed a lower risk of atrial fibrillation with exercise, the link has remained inconclusive in part because those studies relied on self-reporting by participants, a less than exact science,” says senior author Steven Lubitz, MD, MPH, an investigator in the Division of Cardiology at MGH. “Wearable accelerometers, on the other hand, provide an objective and reproducible measure of physical activity. What we found was that activity in accordance with guideline recommendations is indeed associated with substantially lower risks of both atrial fibrillation and stroke.”
Nearly 100,000 members of the UK Biobank agreed to wear accelerometers – electromagnetic devices that measure body movement and orientation to infer certain activities – for seven days. MGH researchers then compared that data with later diagnoses of atrial fibrillation and stroke among participants, most between 55 and 70 years of age, reported to the Biobank from 2013 to 2020.
“Our findings supported recommendations from the European Society of Cardiology, the American Heart Association, and the World Health Organization for 150 minutes or greater of moderate to vigorous physical activity per week,” notes lead author Shaan Khurshid, MD, an investigator in the Division of Cardiology at MGH.
Given the explosive growth of “smart” devices with increasingly sophisticated detection capabilities, the study stressed the exciting opportunities that now exist to link disease prevention programs to atrial fibrillation diagnostics. Those devices include wearables and smartphones able to measure heart rate and thus detect possible arrhythmias and other irregularities through their photoplethysmography (a technique that detects changes in blood flow through sensors on the skin) and electrocardiographic (ECG) capabilities.
“It’s not hard to imagine how these devices could be used by physicians and patients to achieve a level of physical activity which we know to be associated with a reduced risk of atrial fibrillation,” explains Lubitz. “And by potentially identifying Afib through photoplethysmography and electrocardiography, users could be alerted to seek professional care before a stroke develops.”
Lubitz is hopeful that these emerging technologies could be applied to not just Afib and stroke but also to other forms of cardiovascular disease, including hypertension, and to metabolic diseases like diabetes, which might be affected by guideline-adherent physical activity. “Wearable devices capable of objective activity monitoring, motivational messaging, and disease detection could be low-cost, highly effective interventions to improve health outcomes for countless numbers of people.”
Lubitz is a cardiac electrophysiologist at MGH and associate professor of Medicine at Harvard Medical School. Khurshid is a clinical and research fellow in cardiology at MGH. Other co-authors include Emelia Benjamin, MD, ScM, professor of Medicine and Epidemiology at the Boston University Schools of Medicine and Public Health; Patrick Ellinor, MD, PhD, director of the Cardiac Arrhythmia Service at MGH; Ludovic Trinquart, PhD, associate professor of Biostatistics at Boston University School of Public Health; and David McManus, MD, chair of the Department of Medicine at University of Massachusetts Medical School.
The researchers were supported by the National Institutes of Health, the American Heart Association, and Robert Wood Johnson.
About the Massachusetts General Hospital
Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. In August 2020, Mass General was named #6 in the U.S. News & World Report list of "America’s Best Hospitals."
 “Accelerometer-derived physical activity and risk of atrial fibrillation”, by Shaan Khurshid et al. European Heart Journal. doi:10.1093/eurheartj/ehab250.
After publication, the paper can be found at: https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehab250