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The influence of aerobic fitness on electrocardiographic and heart rate variability parameters in young and older adults

  • Tristan W. Dorey
    Affiliations
    School of Health and Human Performance, Division of Kinesiology, Dalhousie University, Halifax B3H 4R2, Nova Scotia, Canada

    Libin Cardiovascular Institute of Alberta, Department of Cardiac Sciences, Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary T2N 4N1, Alberta, Canada
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  • Myles W. O'Brien
    Affiliations
    School of Health and Human Performance, Division of Kinesiology, Dalhousie University, Halifax B3H 4R2, Nova Scotia, Canada
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  • Derek S. Kimmerly
    Correspondence
    Corresponding author at: School of Health and Human Performance, Division of Kinesiology, Dalhousie University, 6230 South Street, Halifax B3H 4R2, Nova Scotia, Canada.
    Affiliations
    School of Health and Human Performance, Division of Kinesiology, Dalhousie University, Halifax B3H 4R2, Nova Scotia, Canada
    Search for articles by this author
Published:January 28, 2019DOI:https://doi.org/10.1016/j.autneu.2019.01.004

      Highlights

      • Ageing produces longer periods of atrial depolarization.
      • Greater aerobic fitness is linked with longer atrial electrical conduction times.
      • Older, fit adults have longer atrial durations vs. young and less fit older adults.
      • This latter finding may be due to enhanced vagal tone and/or cardiac remodeling.

      Abstract

      Long-term endurance training is associated with an increased risk of atrial arrhythmia in older adults (OA). We tested the hypothesis that Aerobically-Fit OA would have prolonged indices related to atrial arrhythmias (e.g. PR-intervals and P durations) compared to younger adults (YA) and Aerobically-Unfit OA. 10–minute stable supine electrocardiogram (ECG) recordings were collected at 1000 Hz in 15 YA (4F, 22 ± 2 years, 50.7 ± 8.5 ml/kg/min), 11 Aerobically-Unfit OA (6♀, 63 ± 7 years, 25.2 ± 2.3 ml/kg/min) and 10 Aerobically-Fit OA (4F, 64 ± 3 years, 45.5 ± 7.0 ml/kg/min) to assess ECG morphology and spectral indices of heart rate variability. In the pooled sample, age was a predictor of PR-interval (r = 0.75) and P wave duration (r = 0.80) (both, p < 0.01). Regardless of age, aerobic fitness was positively associated with PR interval duration (r = 0.81; p < 0.01). Aerobically-Fit OA had prolonged PR-intervals (187 ± 17 vs 161 ± 14 vs. 168 ± 20 ms) and P-wave durations (123 ± 9 vs. 97 ± 9 vs. 96 ± 9 ms) compared to YA and Aerobically-Unfit OA, respectively (all, p < 0.05). In addition, Aerobically-Fit OA had greater normalized high-frequency (HF) power compared to Aerobically-Unfit OA (40.7 ± 4.5nu vs. 30.1 ± 14.2 ± nu; p = 0.03) suggestive of enhance parasympathetic tone. These data highlight that the combination of age-related electrical remodeling and enhanced vagal tone in OA with higher aerobic fitness may contribute to prolongation of atrial-related ECG indices. This is further supported by the correlation between HF power and PR-interval duration (r = 0.45; p = 0.02). These findings may help identify older individuals at risk for atrial arrhythmias who are otherwise free of cardiovascular disease.

      Keywords

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      References

        • Abdulla J.
        • Nielsen J.R.
        Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis.
        Europace. 2009; 11: 1156-1159https://doi.org/10.1093/europace/eup197
        • Ariyarajah V.
        • Mercado K.
        • Apiyasawat S.
        • Puri P.
        • Spodick D.H.
        Correlation of left atrial size with P-wave duration in interatrial block.
        Chest. 2005; 128: 2615-2618https://doi.org/10.1378/chest.128.4.2615
        • Crump C.
        • Sundquist J.
        • Winkleby M.A.
        • Sundquist K.
        Height, weight, and aerobic fitness level in relation to the risk of atrial fibrillation.
        Am. J. Epidemiol. 2018; 187: 417-426https://doi.org/10.1093/aje/kwx255
        • CSEP
        Canadian Society for Exercise Physiology – Physical Activity Training for Health.
        (Ottawa, Ontario)2013
        • Franklin B.A.
        • McCullough P.A.
        Cardiorespiratory fitness: an independent and additive marker of risk stratification and health outcomes.
        Mayo Clin. Proc. 2009; 84 (Elsevier): 776-779https://doi.org/10.4065/84.9.776
        • Goodman J.M.
        • Banks L.
        • Connelly K.A.
        • Yan A.
        • Backx P.H.
        • Dorian P.
        Excessive exercise in endurance athletes: is atrial fibrillation a possible consequence?.
        Appl. Physiol. Nutr. Metab. 2018; https://doi.org/10.1139/apnm-2017-0764
        • Havmoller R.
        • Carlson J.
        • Holmqvist F.
        • Herreros A.
        • Meurling C.J.
        • Olsson B.
        • Platonov P.
        Age-related changes in P wave morphology in healthy subjects.
        BMC Cardiovasc. Disord. 2007; 7 (BioMed Central): 22https://doi.org/10.1186/1471-2261-7-22
        • Hosseini S.M.
        • Jamshir M.
        Valsalva maneuver and strain-related ECG changes.
        Res. Cardiovasc. Med. 2015; 4 (Kowsar Medical Institute)e28136https://doi.org/10.5812/cardiovascmed.28136
        • Kasser I.
        • Kennedy J.W.
        The relationship of increased left atrial volume and pressure to abnormal P waves on the electrocardiogram.
        Circulation. 1969; 39: 339-343https://doi.org/10.1161/circ.39.3.339
        • Kokkinos P.
        Physical activity, health benefits, and mortality risk.
        ISRN Cardiol. 2012; 2012 (Hindawi Limited)718789https://doi.org/10.5402/2012/718789
        • Laukkanen J.A.
        • Kurl S.
        • Salonen R.
        • Rauramaa R.
        • Salonen J.T.
        The predictive value of cardiorespiratory fitness for cardiovascular events in men with various risk profiles: a prospective population-based cohort study.
        Eur. Heart J. 2004; 25 (Downloaded from): 1428-1437https://doi.org/10.1016/j.ehj.2004.06.013
        • Mandsager K.
        • Harb S.
        • Cremer P.
        • Phelan D.
        • Nissen S.E.
        • Jaber W.
        Association of cardiorespiratory fitness with long-term mortality among adults undergoing exercise treadmill testing.
        JAMA Netw. Open. 2018; 1 (American Medical Association)e183605https://doi.org/10.1001/jamanetworkopen.2018.3605
        • Mirza M.
        • Strunets A.
        • Shen W.-K.
        • Jahangir A.
        Mechanisms of arrhythmias and conduction disorders in older adults.
        Clin. Geriatr. Med. 2012; 28: 555-573https://doi.org/10.1016/j.cger.2012.08.005
        • Molina L.
        • Mont L.
        • Marrugat J.
        • Berruezo A.
        • Brugada J.
        • Bruguera J.
        • Rebato C.
        • Elosua R.
        Long-term endurance sport practice increases the incidence of lone atrial fibrillation in men: a follow-up study.
        Europace. 2008; 10: 618-623https://doi.org/10.1093/europace/eun071
        • Müssigbrodt A.
        • Weber A.
        • Mandrola J.
        • van Belle Y.
        • Richter S.
        • Döring M.
        • Arya A.
        • Sommer P.
        • Bollmann A.
        • Hindricks G.
        Excess of exercise increases the risk of atrial fibrillation.
        Scand. J. Med. Sci. Sports. 2017; 27 (Wiley/Blackwell): 910-917https://doi.org/10.1111/sms.12830
        • Myrstad M.
        • Løchen M.-L.
        • Graff-Iversen S.
        • Gulsvik A.K.
        • Thelle D.S.
        • Stigum H.
        • Ranhoff A.H.
        Increased risk of atrial fibrillation among elderly Norwegian men with a history of long-term endurance sport practice.
        Scand. J. Med. Sci. Sports. 2014; 24 (Wiley/Blackwell): e238-e244https://doi.org/10.1111/sms.12150
        • Nielsen J.B.
        • Kühl J.T.
        • Pietersen A.
        • Graff C.
        • Lind B.
        • Struijk J.J.
        • Olesen M.S.
        • Sinner M.F.
        • Bachmann T.N.
        • Haunsø S.
        • Nordestgaard B.G.
        • Ellinor P.T.
        • Svendsen J.H.
        • Kofoed K.F.
        • Køber L.
        • Holst A.G.
        P-wave duration and the risk of atrial fibrillation: results from the Copenhagen ECG study.
        Heart Rhythm. 2015; 12: 1887-1895https://doi.org/10.1016/j.hrthm.2015.04.026
        • O'Brien M.W.
        • Robinson S.A.
        • Frayne R.J.
        • Mekary S.
        • Fowles J.R.
        • Kimmerly D.S.
        Achieving Canadian physical activity guidelines is associated with better vascular function independent of aerobic fitness and sedentary time in older adults.
        Appl. Physiol. Nutr. Metab. 2018; 43: 1003-1009https://doi.org/10.1139/apnm-2018-0033
        • Opondo M.A.
        • Aiad N.
        • Cain M.A.
        • Sarma S.
        • Howden E.
        • Stoller D.A.
        • Ng J.
        • van Rijckevorsel P.
        • Hieda M.
        • Tarumi T.
        • Palmer M.D.
        • Levine B.D.
        Does high-intensity endurance training increase the risk of atrial fibrillation? A longitudinal study of left atrial structure and function.
        Circ. Arrhythm. Electrophysiol. 2018; 11 (American Heart Association, Inc.)e005598https://doi.org/10.1161/CIRCEP.117.005598
        • Park J.
        • Kim T.-H.
        • Lee J.S.
        • Park J.K.
        • Uhm J.S.
        • Joung B.
        • Lee M.H.
        • Pak H.-N.
        Prolonged PR interval predicts clinical recurrence of atrial fibrillation after catheter ablation.
        J. Am. Heart Assoc. 2014; 3 (American Heart Association, Inc.)e001277https://doi.org/10.1161/JAHA.114.001277
        • Piccirillo G.
        • Ogawa M.
        • Song J.
        • Chong V.J.
        • Joung B.
        • Han S.
        • Magrì D.
        • Chen L.S.
        • Lin S.-F.
        • Chen P.-S.
        Power spectral analysis of heart rate variability and autonomic nervous system activity measured directly in healthy dogs and dogs with tachycardia-induced heart failure.
        Heart Rhythm. 2009; 6: 546-552https://doi.org/10.1016/j.hrthm.2009.01.006
        • Rosenberg M.A.
        • Patton K.K.
        • Sotoodehnia N.
        • Karas M.G.
        • Kizer J.R.
        • Zimetbaum P.J.
        • Chang J.D.
        • Siscovick D.
        • Gottdiener J.S.
        • Kronmal R.A.
        • Heckbert S.R.
        • Mukamal K.J.
        The impact of height on the risk of atrial fibrillation: the cardiovascular health study.
        Eur. Heart J. 2012; 33: 2709-2717https://doi.org/10.1093/eurheartj/ehs301
        • Schnohr P.
        • O'Keefe J.H.
        • Marott J.L.
        • Lange P.
        • Jensen G.B.
        Dose of jogging and long-term mortality.
        J. Am. Coll. Cardiol. 2015; 65: 411-419https://doi.org/10.1016/j.jacc.2014.11.023
        • van den Berg M.P.
        • Hassink R.J.
        • Baljé-Volkers C.
        • Crijns H.J.G.M.
        Role of the autonomic nervous system in vagal atrial fibrillation.
        Heart. 2003; 89 (BMJ Publishing Group. Available from http://www.ncbi.nlm.nih.gov/pubmed/12591850 [accessed 9 June 2018]): 333-335
        • Vandenberk B.
        • Vandael E.
        • Robyns T.
        • Vandenberghe J.
        • Garweg C.
        • Foulon V.
        • Ector J.
        • Willems R.
        Which QT correction formulae to use for QT monitoring?.
        J. Am. Heart Assoc. 2016; 5 (American Heart Association, Inc.)e003264https://doi.org/10.1161/JAHA.116.003264
        • Wilhelm M.
        • Roten L.
        • Tanner H.
        • Wilhelm I.
        • Schmid J.-P.
        • Saner H.
        Atrial remodeling, autonomic tone, and lifetime training hours in nonelite athletes.
        Am. J. Cardiol. 2011; 108: 580-585https://doi.org/10.1016/j.amjcard.2011.03.086