Exercise intervention maintains sinus rhythm, reduces severity of AF symptoms

August 28, 2021

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Elliott A. Latest Science in Arrhythmias and Device Therapy. Presented at: Congress of the European Society of Cardiology; 27.-30. August 2021 (virtual meeting).

Disclosure:
Elliott does not report any relevant financial information.

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Adults with symptomatic AF who followed a 6 month training intervention that combined supervised exercise and physical activity at home showed significant improvements in AF freedom and symptom severity compared to usual treatment.

“We observed all of these changes with no notable differences in blood pressure, body mass index or heart function and remodeling measurements in the training group compared to our control group”, Adrian Elliott, PhD, MSc, physiologist at the University of Adelaide, Australia, said during a presentation at the European Society of Cardiology Congress. “Exercise and exercise should be recommended in patients with atrial fibrillation to help maintain sinus rhythm and reduce the severity of symptoms associated with atrial fibrillation.”

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The randomized study included 120 patients with symptomatic paroxysmal or persistent AF, whose weekly physical activity was less than 60 minutes (mean age 65 years; 42% women; mean BMI 31 kg / m2). Half of the cohort was randomly assigned to exercise intervention and the other half to standard care. The patients in the training intervention group participated in supervised training visits and increased their training at home by 20% per week to up to 210 minutes per week. Those who were assigned the usual care were educated about the benefits of physical activity and were advised to participate in 150 minutes of physical activity per week. After 3 months, repeated visits were made to increase the value of physical activity.

After 6 months, the patients in the training intervention group participated in an average of 18 supervised training visits and achieved an average of 177 minutes of physical activity at home.

The co-primary endpoints were AF freedom and AF symptom severity as measured by the AF Symptom Severity Questionnaire at 6 months and 12 months. Approximately 40% of the patients in the training intervention group were free of atrial fibrillation after 1 year compared to 20% of the patients in the normal care group (HR = 0.5; 95% CI 0.33-0.78; P = 0.0018) . Those in the training intervention group showed greater improvements in the severity of AF symptoms compared to the normal care group both after 6 months (P = .033) and after 12 months (P = .041).

After 12 months, the overall AF symptom exposure and frequency of AF symptoms were lower in the training intervention group. There was no difference in the duration of AF symptoms.

“The effectiveness of our intervention to improve cardiorespiratory fitness can be seen in the improvement in peak oxygen consumption after 6 months,” said Elliott during the presentation. “What is important is that these differences persisted after 12 months, which suggests that these cardiopulmonary adjustments were permanent. … [W]We did not observe any significant change in body mass index or blood pressure with the exercise intervention, suggesting that these benefits of exercise and physical activity were achieved independently of changes in other risk factors such as obesity and high blood pressure. “

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European Society of Cardiology

European Society of Cardiology

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