IJCS | Volume 32, Nº4, July/August 2019

389 1. Benjamin EJ, Wolf PA, D'Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the FraminghamHeart Study. Circulation. 1998; 98(10):946-52. 2. WattigneyWA, MensahGA, Croft JB. Increasing trends in hospitalization for atrial fibrillation in the United States, 1985 through 1999: implications for primary prevention. Circulation. 2003;108(6):711-6. 3. Osbak PS, Mourier M, Henriksen JH, Kofoed KF, Jensen GB. Effect os physical exercise training onmuscle strength and body composition, and their association with functional capacity and quality os life in patients with atrial fibrillation: a randomized controlled trial. J Rehabil Med 2012;44(11):975-9. 4. Aizer A, Gaziano JM, Cook NR, Manson JE, Buring JE, Albert CM. Relation of vigorous exercise to risk of atrial fibrillation. Am J Cardiol. 2009;103(11):1572-7. 5. Azarbal F, StefanickML, Salmoirago-Blotcher E, Manson JE, Albert CM, LaMonte MJ, et al. Obesity, physical activity, and their interaction in incident atrial fibrillation in postmenopausal women. J AmHeart Assoc. 2014;3(4):pii.e001127 6. Bapat A, Zhang Y, Post WS, Guallar E, Soliman EZ, Heckbert SR, et al. Relation of physical activity and incident atrial fibrillation (from the Multi-Ethnic Study of Atherosclerosis). Am J Cardiol. 2015;116(6):883-8. References Garlipp et al. Physical activity and atrial fibrillation Int J Cardiovasc Sci. 2019;32(4):384-390 Original Article been shown that high-intensity exercises do not increase risk and that patients tolerate exercises of this type. Regular practice of physical activity has been reported to increase vagal tonus due to physiological adaptations resulting from increased cardiac work, 34 inducing electrical stability of the heart andmaintenance of homeostasis. In this sense, low resting HR tends to represent a good health picture. 35 Thus, well-trained or physically conditioned individuals have lower resting HR, which suggests greater parasympathetic activity 36 or less sympathetic activity. 37 Still, Uusitalo et al., 38 and Bonaduce et al., 39 doing studies with longitudinal characteristics, observed a reduction in resting HR, although significant abnormalities in the autonomic indicators were not identified. Thus, Catai et al., 40 suggest that exercise-induced bradycardia may result from intrinsic sinus node adaptations. Like any systematic review, this study also presents limitations, since the results demonstrated here are limited by the quality of the studies available. This way, trying to make a complete literature review, all studies available, on the proposed theme, were included, and were evaluated, however, with a robust quality meta- analysis technique. In addition, the data analyzed were not stratified by type of exertion, gender or age. Conclusion It is concluded, therefore, that physical exercise, lato sensu, without stratification by intensity, sex or age, does not seem to be associated with an increase in the occurrence of atrial fibrillation. Acknowledge The postgraduate team of the Institute of Cardiology of Porto Alegre. Author contributions Conception and design of the research: Garlipp DC, Leiria TLL. Acquisition of data: Garlipp DC, Guimarães RB, Savaris SL, Froemming Junior C, Dutra O. Analysis and interpretation of the data: Garlipp DC, Guimarães RB, Savaris SL, Froemming Junior C, Dutra O, Leiria TLL. Statistical analysis: Froemming Junior C, Leiria TLL. Writing of the manuscript: Garlipp DC, Guimarães RB, Savaris SL, Froemming Junior C, Dutra O, Leiria TLL. Critical revision of the manuscript for intellectual content: Leiria TLL. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This article is part of the thesis of postgraduate submitted by Daniel Carlos Garlipp, from Instituto de Cardiologia / Fundação Universitária de Cardiologia do Rio Grande do Sul . Ethics approval and consent to participate This study was approved by the Ethics Committee of the IC/FUC under the protocol number 1797.204. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study.