Cardiovascular exercise and burden of arrhythmia in patients with atrial fibrillation - A randomized controlled trial

Abstract

BackgroundPhysical activity at moderate-high intensity is recommended to prevent lifestyle diseases. Patients with atrial fibrillation are at risk of a sedentary lifestyle due to fear of exercise-induced episodes of atrial fibrillation. The burden of arrhythmia can be reduced by physical exercise. The effect of exercise intensity on burden of atrial fibrillation needs to be studied further.Methods and resultsIn a 12-week randomized controlled trial, 76 patients with paroxysmal/persistent atrial fibrillation were allocated to perform exercise at either low intensity or high intensity (50% and 80% of maximal perceived exertion, respectively). Primary outcome was burden of AF measured by daily electrocardiography-reporting during 12 weeks. Secondarily, change in maximal oxygen uptake (peak VO2) and 1-year hospitalization was compared between low and high intensity exercise. Sixty-three patients completed the follow-up. In the intention-to-treat analysis, we found no statistical difference in burden of atrial fibrillation between low and high intensity exercise (incidence rate ratio 0.742, 95% CI 0.29–1.91, P = 0.538). No serious adverse events were reported and there was no difference in hospitalization between the two exercise groups. Both exercise groups improved significantly in peak VO2 (low intensity: 3.62 mL O2/kg/min, SD 3.77; high intensity: 2.87 mL O2/kg/min, SD 4.98), with no statistical difference between-groups (mean difference: 0.76 mL O2/kg/min, 95% CI -3.22–1.7).ConclusionsHigh intensity physical exercise was not superior to low intensity physical exercise in reducing burden of atrial fibrillation. HI exercise was well tolerated; no evidence of an increased risk was found for HI compared to LI exercise. Larger studies are required to further prove our findings.Trial registrationClinicalTrials.gov NCT01817998

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

“…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).…”

“…HRQoL in patients with AF has been shown to be lower than age and sex-matched members of the general population and other cardiac groups, including coronary heart disease (CHD). 9 Beyond medical management, evidence suggests AF may be controlled by improving lifestyle 10 11. One aspect of lifestyle therapy that is poorly understood, with respect to AF, is regular exercise 12…”

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

“…Pathak et al also demonstrated a beneficial effect of aggressive risk factor management on the long-term success of AF ablation (6). Randomized studies on patients with primarily permanent AF have demonstrated beneficial effects of physical exercise on physical capacity, AF symptoms and QoL (7)(8)(9)(10)(11).…”

The Effects of 8 Weeks Pilates, Walking, and Combined Pilates and Walking on Heart Arrhythmia

“…In a study that examined the effects of the intensity of aerobic exercise on systolic blood pressure both in resting and during the exercise, the results showed that exercise with low and extreme intensity leads to an increase in systolic blood pressure (30). Findings of research on the study of the effects of doing exercise on arterial fibrillation arrhythmia demonstrated that exercise with extreme intensity had no superiority to reduce arterial fibrillation compared to low-intensity exercise (31). Several known mechanisms can be described for blood pressure loss due to exercise.…”