Exercise intervention reduces recurrence, symptom severity in patients with AF
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In patients with atrial fibrillation, participating in an exercise-based intervention for 6 months reduced AF recurrence and improved symptom severity compared with controls, researchers reported.
Prashanthan Sanders, MBBS, PhD, director of the Centre for Heart Rhythm Disorders at the University of Adelaide and Royal Adelaide Hospital, Australia, and colleagues conducted the randomized controlled ACTIVE-AF trial of 120 patients (mean age, 65 years; 43% women) with paroxysmal or persistent symptomatic AF.
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Patients were assigned to the usual care or to an exercise intervention combining home and supervised aerobic exercise for 6 months. The supervised one-on-one aerobic sessions were conducted weekly for the first 3 months and biweekly for the second 3 months.
The first primary outcome of freedom from AF without antiarrhythmic medications or catheter ablation at 12 months occurred in 40% of the intervention group and 20% of the control group (HR = 0.5; 95% CI, 0.33-0.78), according to the researchers.
AF symptom severity at 6 months, the second primary outcome, was lower in the intervention group than the control group (mean difference, –2.3; 95% CI, –4.3 to –0.2; P = .033), the researchers wrote, noting the difference remained at 12 months (mean difference, –2.3; 95% CI, –4.5 to –0.1; P = .041).
Total symptom burden was lower in the intervention group at 6 months but did not differ between the groups at 12 months, Sanders and colleagues wrote.
Peak oxygen consumption was higher in the intervention group than in the control group at 6 months (mean difference, 1.6 mL/kg per minute; 95% CI, 0.5-2.7) and at 12 months (mean difference, 1.8 mL/kg per minute; 95% CI, 0.3-3.2), according to the researchers.
There were no differences between the groups in cardiac structure or function, BMI or BP, the researchers found.
“This study reaffirms the role of lifestyle modification for patients in the management of AF,” Sanders and colleagues wrote. “Importantly, the model of exercise intervention delivered within this study combines both supervised exercise with home-based physical activity, potentially increasing the likelihood of translation into clinical care.”
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