Multiple non-sustained AF episodes are prior to this stage and have independent clinical outcomes(3). The incidence of AHRE in the MOST trial was 51%, which is significantly higher than our finding (28.5%). This can be associated with a longer follow-up duration in the MOST trial and the inclusion of the population with different baseline characteristics. The solid evidence related to adverse outcomes of even asymptomatic AF necessitated researchers to identify and manage the modifiable risk factors to prevent AF. Obesity is not only an independent risk factor for AF, but also contributes to the progression of paroxysmal AF to permanent AF(7,8,14). However, patients with only symptomatic AF were included in these studies. Our data demonstrated that increased BMI is an independent risk factor for asymptomatic AF as well. Several studies have investigated the effect of risk factor management on the incidence, symptom burden, and outcome of AF with both short- and longterm follow-up(9,15-17). Among these, goaldirected, long-term, sustained weight loss was associated with a reduction in AF severity and burden in the Bozbeyoğlu E, Çinier G. ● Koşuyolu Heart J 2018;21(3):230-235 233 Table 2. Multivariate logistic regression analysis of parameters associated with AHRE 95% CI OR p Atrial high rate episodes, ACE: Angiotensin converting enzyme, SD: Standard deviation, BMI: Body mass index, LA-AP: Left atrium antero-posterior, LVEDD: Left ventricle end-diastolic diameter, LVESD: Left ventricle endsystolic diameter, EF: Ejection fraction, LAV: Left atrium volume. 234 Koşuyolu Heart J 2018;21(3):230-235 ● Increased Body Mass Index is Associated with Device Detected Silent Atrial Fibrillation LEGACY trial. The maintenance of sinus rhythm was facilitated by weight management during the 5-year follow-up period. There was no previous study reporting the direct relation between mean resting heart rate and AF. However, mean resting heart rate often coexists with comorbid conditions associated with AF, including hypertension, atherosclerosis, and diabetes mellitus(18). In hypertensive patients, increased resting heart rate in sinus rhythm was a predictor of newonset AF independent from the effect of arterial pressure lowering treatment. This finding was attributed to the increased effect of sympathetic activity, which promotes AF through several pathways(19). In conclusion, patients with higher BMI (30 kg/m2 ) are more likely to have asymptomatic AF episodes. The results of the present study highlight the importance of screening high-risk patients (such as obese and physically inactive patients) for AF and to intervene necessary lifestyle habits before AF develops to prevent detrimental adverse outcomes including stroke and heart failure. Study Limitations The present study has several inherent limitations. First, this is a singlecenter study with a limited number of patients. Second, there are several diagnostic criteria for defining AHRE in literature. We adopted AHRE faster than 220 bpm and longer than 5 minutes. Using different criteria for AHRE would lead results different from those of the present study. Third, other diagnostic tools including long-term ECG and Holter monitoring can be used for detecting silent AF. Among those tools, we included only AHRE detection by cardiac PM. Different results can be obtained by using a variety of diagnostic methods for the detection of silent AF. Conflict of Interest The authors declare that they have no conflict of interest related to this article. AUTHORSHIP CONTRIBUTIONS Concept/Design: EB, GÇ Analysis/Interpretation: EB Data Acquisition: GÇ Writting: GÇ Critical Revision: EB Final Approval: All of auth Physically active individuals sleep better, feel better, and function better. The 2018 Scientific Report demonstrates that, in addition to disease prevention benefits, regular physical activity provides a variety of benefits that help individuals sleep better, feel better, and perform daily tasks more easily. • Strong evidence demonstrates that moderate-to-vigorous physical activity improves the quality of sleep. It does so by reducing the length of time it takes to go to sleep and reducing the time one is awake after going to sleep and before arising in the morning. It also can increase the time in deep sleep and reduce daytime sleepiness. • Single episodes of physical activity promote acute improvements in executive function for a period of time. 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