Associations Between Accelerometer-Measured 24-Hour Movement Behaviors and Cardiac Conduction Disease in the UK Biobank Cohort

Abstract

Background and Objectives: Daily activity has a distinct hierarchy of movement behaviors. The association between 24-hour movement behaviors and cardiac conduction disease (CCD) remains unclear. We aimed to investigate the association between accelerometer-measured 24-hour movement behaviors and CCD risk. Methods: A total of 92,436 UK Biobank participants who wore wrist accelerometers for 7 consecutive days were included, with a median follow-up of 6.1 years. Multivariable Cox proportional hazards models were used to investigate the associations between 24-hour movement behaviors (sleep, sedentary behavior, light-intensity physical activity [LIPA], and moderate-to-vigorous intensity physical activity [MVPA]) and the risk of CCD. Compositional data analysis was performed to estimate the effects of reallocating time among 24-hour movement behaviors. Results: Among the 92,436 participants (median age 58 years; interquartile range, 50-63; 54% female), 1,442 developed incident CCD (2.58 per 1,000 person-years) during the follow up. Greater sedentary behavior was associated with an increased risk of CCD (hazard ration [HR], 1.05; 95% confidence interval [CI], 1.02-1.08), whereas higher MVPA was associated with a lower risk (HR, 0.83; 95% CI, 0.75-0.92). Sleep duration and LIPA were not significantly associated with CCD risk. Reallocating 30 min/day to MVPA from other movement behaviors was associated with a 4% lower risk of CCD (HR, 0.96; 95% CI, 0.93-0.98). Conversely, reallocating 30 minutes/day to sedentary behavior was associated with a 3% increased risk (HR, 1.03; 95% CI, 1.01-1.05). Similar patterns were observed for specific CCD outcomes, including second-or third-degree atrioventricular block and pacemaker implantation. Conclusions: Higher volumes of MVPA were associated with a lower risk of CCD, whereas increased sedentary behavior was associated with higher risk, highlighting the importance of preventive activity patterns.