Cardiac rehabilitation versus usual care for patients treated with catheter ablation for atrial fibrillation: Results of the randomized CopenHeartRFA trial

Risom, Signe Stelling; Zwisler, Ann-Dorthe; Rasmussen, Trine Bernholdt; Sibilitz, Kirstine Lærum; Madsen, Trine L. S.; Svendsen, Jesper Hastrup; Gluud, Christian; Lindschou, Jane; Winkel, Per; Berg, Selina Kikkenborg

doi:10.1016/j.ahj.2016.08.013

Cited by 70 publications

(144 citation statements)

References 28 publications

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“…The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram (figure 1) describes the selection process. Nine studies (nine publications) were included in this analysis2 10 25–31 (see table 1).…”

Section: Resultsmentioning

confidence: 99%

“…The total number of participants in the nine included studies yielded 959 participants, 483 allocated to exercise training and 476 to control. One study, in addition to the exercise component, also included a psycho-educational part of the intervention 29…”

Section: Resultsmentioning

confidence: 99%

“…Evidence from pooled analysis of eight studies2 25–31 showed 52 deaths in 445 (11.7%) exercising participants and 47 deaths in 438 (10.7%) control participants. There was no significant difference in pooled RR between exercise-based CR and control groups (RR 1.08, 95% CI 0.77 to 1.53, p=0.64, I 2 =0%) (figure 2).…”

Section: Resultsmentioning

confidence: 99%

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Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials

et al. 2018

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ObjectiveThe aim of this study was to undertake a contemporary review of the impact of exercise-based cardiac rehabilitation (CR) targeted at patients with atrial fibrillation (AF).MethodsWe conducted searches of PubMED, EMBASE and the Cochrane Library of Controlled Trials (up until 30 November 2017) using key terms related to exercise-based CR and AF. Randomised and non-randomised controlled trials were included if they compared the effects of an exercise-based CR intervention to a no exercise or usual care control group. Meta-analyses of outcomes were conducted where appropriate.ResultsThe nine randomised trials included 959 (483 exercise-based CR vs 476 controls) patients with various types of AF. Compared with control, pooled analysis showed no difference in all-cause mortality (risk ratio (RR) 1.08, 95% CI 0.77 to 1.53, p=0.64) following exercise-based CR. However, there were improvements in health-related quality of life (mean SF-36 mental component score (MCS): 4.00, 95% CI 0.26 to 7.74; p=0.04 and mean SF-36 physical component score: 1.82, 95% CI 0.06 to 3.59; p=0.04) and exercise capacity (mean peak VO2: 1.59 ml/kg/min, 95% CI 0.11 to 3.08; p=0.04; mean 6 min walk test: 46.9 m, 95% CI 26.4 to 67.4; p<0.001) with exercise-based CR. Improvements were also seen in AF symptom burden and markers of cardiac function.ConclusionsExercise capacity, cardiac function, symptom burden and health-related quality of life were improved with exercise-based CR in the short term (up to 6 months) targeted at patients with AF. However, high-quality multicentre randomised trials are needed to clarify the impact of exercise-based CR on key patient and health system outcomes (including health-related quality of life, mortality, hospitalisation and costs) and how these effects may vary across AF subtypes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials

et al. 2018

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“…Risom et al (26) conducted a 12-week randomized trial on rehabilitation for patients with paroxysmal or persistent AF after catheter ablation. The authors found an improved physical capacity assessed by VO 2 peak, which is in line with our results.…”

Section: Discussionmentioning

confidence: 99%

Effect of patient education and physical training on quality of life and physical exercise capacity in patients with paroxysmal or persistent atrial fibrillation: A randomized study

et al. 2019

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Atrial fibrillation is the most common cardiac arrhythmia and the number of atrial fibrillation patients is growing worldwide. In addition to an increase in risk of stroke and heart failure patients with atrial fibrillation also experience decrease in fitness and quality of life. In our study 58 atrial fibrillation patients draw lots to participate or not in a rehabilitation program with education and exercise training in addition to usual treatment. We measured fitness by a bicycle test at the beginning of the study and after 3 and 6 months, moreover participants filled out questionnaires on quality of life at the beginning of the study and after 3, 6 and 12 months. We found that our rehabilitation program may have a short term (but no long term) effect on quality of life and fitness in atrial fibrillation patients. Objective: To examine the effect of a rehabilitation programme on quality of life and physical capacity in patients with atrial fibrillation. Methods: Patients with paroxysmal or persistent atrial fibrillation were randomized to either a 12week rehabilitation programme with education and physical training (intervention group) or standard care (control group). At baseline, after 3, 6 and 12 months participants completed 5 different quality of life questionnaires (Quality of Life in patients with Atrial Fibrillation (AF-QoL-18), Atrial Fibrillation Effect on QualiTy of Life (AFEQT), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Assessment (GAD-7) and EuroQol 5D (EQ-5D)), and physical exercise tests. Differences in mean] scores between groups were analysed by repeated measures analysis of variance (ANOVA). Results: Fifty-eight patients (age range 43-78 years, 31% female) were included. In the intervention group the AF-QoL-18 score increased from baseline (48.4 (standard deviation (SD) 22.8)) to 6 months (68.0 (SD 15.2)) compared with the control group (baseline 51.6 (SD 22.3), 6 months 59.2 (SD 27.3)). After 12 months, there was no difference. Similar patterns were found for the other questionnaires. Maximum exercise capacity improved in the intervention group from baseline (176 W (SD 48)) to 6 months (190 W (SD 55)). There was no change in the control group. Conclusion: Education and physical training may have a short-term (but no long-term) beneficial effect on quality of life and physical exercise capacity in patients with atrial fibrillation.

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“…The full week schedule is provided in appendix (Figure A1 in Appendix ). At REHPA, participants were introduced to an exercise diary shown to be effective in other patient groups independent of exercise setting (Risom et al., ; Sibilitz et al., ; Tang et al., ). Participants were encouraged to exercise three times a week during the 3 months up until follow‐up accordingly to the dairy.…”

Section: Methodsmentioning

confidence: 99%

The effectiveness of exercise-based rehabilitation to patients with myeloproliferative neoplasms-An explorative study

et al. 2018

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The aim of the study was to determine the impact of an interdisciplinary exercise-based rehabilitation intervention on fatigue and quality of life (QOL) in patients with Philadelphia-negative myeloproliferative neoplasms (MPNs). At the Danish Knowledge Centre for Rehabilitation and Palliative Care, a 5-day interdisciplinary exercise-based rehabilitation intervention was carried out on 48 patients with MPN. It was followed by 12 weeks of self-exercising prior to follow-up. Initially and at follow-up, participants filled out validated questionnaires; Brief Fatigue Inventory, Multidimensional Fatigue Inventory, European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire, Myeloproliferative Neoplasm Symptom Assessment Form and Hospital Anxiety and Depression Scale. Maximal oxygen uptake and muscular strength were tested as well. Paired t test was used to compare scores between baseline and follow-up. In total, 45 participants (94%) completed the follow-up. No significant differences were observed on fatigue or QOL when comparing baseline and follow-up. Mean maximal oxygen uptake increased from 27.2 to 33.6 ml O · kg ·min (p < 0.001). Handgrip strength (p = 0.01) and the 30-s chair-stand test (p < 0.001) improved as well. No changes were found regarding levels of fatigue and QOL. However, we observed a significant increase in the physical capacity. Our observations call for further studies investigating the effects of non-pharmacological approaches in patients with MPN.

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Cardiac rehabilitation versus usual care for patients treated with catheter ablation for atrial fibrillation: Results of the randomized CopenHeartRFA trial

Cited by 70 publications

References 28 publications

Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials

Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials

Effect of patient education and physical training on quality of life and physical exercise capacity in patients with paroxysmal or persistent atrial fibrillation: A randomized study

The effectiveness of exercise-based rehabilitation to patients with myeloproliferative neoplasms-An explorative study

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