Life’s Simple 7 in relation to supraventricular and ventricular arrhythmias on extended ambulatory cardiac monitoring: The Multi-Ethnic Study of Atherosclerosis

Background: The Life’s Simple 7 (LS7) metric consists of seven health behaviors and measures that are known risk factors for cardiovascular disease. Relatively little is known about the association of LS7 score with cardiac arrhythmias.
Methods: In the setting of the Multi-Ethnic Study of Atherosclerosis (MESA), we studied LS7 score, assessed at the 2010-2102 study visit, in relation to cardiac arrhythmias assessed by Zio Patch ambulatory electrocardiographic monitoring in 2016-2018. In participants free of clinically recognized cardiovascular disease and AF, we examined the association of total LS7 score with atrial fibrillation, supraventricular arrhythmias, and ventricular arrhythmias using logistic regression and linear regression.
Results: Among 1329 participants in the analysis, the mean (SD) age was 67(8) years and 48% were men. More favorable total LS7 score was associated with fewer PVCs per hour (ratio of geometric means for the upper quartile vs. the lower quartile 0.52 [0.34-0.81]). After adjustment for sociodemographic characteristics, the association was attenuated (0.66 [0.43, 1.01]). Among the LS7 components, only body mass index (BMI) was associated with ventricular ectopy. In an adjusted model, compared with participants with poor body mass index (BMI), those with intermediate BMI had a 30% fewer PVCs/hour (ratio of geometric means 0.70 [0.50- 0.96]). We did not detect associations of total LS7 score with atrial arrhythmias.
Conclusion: In this longitudinal study of individuals free of clinically-recognized cardiovascular disease, there was little evidence of association of total LS7 score with cardiac arrhythmias. However, there was a suggestion that more favorable LS7 score was associated with fewer PVCs and specifically, that more favorable BMI was associated with fewer PVCs.