TY - JOUR
T1 - An Exercise and Physical Activity Program in Patients With Atrial Fibrillation
T2 - The ACTIVE-AF Randomized Controlled Trial
AU - Elliott, Adrian D.
AU - Verdicchio, Christian V.
AU - Mahajan, Rajiv
AU - Middeldorp, Melissa E.
AU - Gallagher, Celine
AU - Mishima, Ricardo S.
AU - Hendriks, Jeroen M.L.
AU - Pathak, Rajeev K.
AU - Thomas, Gijo
AU - Lau, Dennis H.
AU - Sanders, Prashanthan
PY - 2023/4
Y1 - 2023/4
N2 - Background: There are limited data on the effect of exercise interventions on atrial fibrillation (AF) recurrence and symptoms. Objectives: The aim of this study was to determine the efficacy of an exercise and physical activity intervention on AF burden and symptoms among patients with symptomatic AF. Methods: This prospective, randomized controlled trial included 120 patients with paroxysmal or persistent, symptomatic AF, randomized 1:1 to receive an exercise intervention, combining home and supervised aerobic exercise over 6 months, or to receive usual care. The coprimary outcomes were: 1) AF recurrence, off antiarrhythmic medications and without catheter ablation; and 2) symptom severity assessed by using a validated questionnaire. Results: By 12 months, freedom from AF was achieved in 24 (40%) of 60 patients in the exercise group and 12 (20%) of 60 patients in the control group (HR: 0.50: 95% CI: 0.33 to 0.78). At 6 months, AF symptom severity was lower in the exercise group compared with the control group (mean difference –2.3; 95% CI: –4.3 to –0.2; P = 0.033). This difference persisted at 12 months (–2.3; 95% CI: –4.5 to –0.1; P = 0.041). Total symptom burden was lower at 6 months in the exercise group but not at 12 months. Peak oxygen consumption was increased in the exercise group at both 6 and 12 months. There were no between-group differences in cardiac structure or function, body mass index, or blood pressure. Conclusions: Participation in an exercise-based intervention over 6 months reduced arrhythmia recurrence and improved symptom severity among patients with AF.
AB - Background: There are limited data on the effect of exercise interventions on atrial fibrillation (AF) recurrence and symptoms. Objectives: The aim of this study was to determine the efficacy of an exercise and physical activity intervention on AF burden and symptoms among patients with symptomatic AF. Methods: This prospective, randomized controlled trial included 120 patients with paroxysmal or persistent, symptomatic AF, randomized 1:1 to receive an exercise intervention, combining home and supervised aerobic exercise over 6 months, or to receive usual care. The coprimary outcomes were: 1) AF recurrence, off antiarrhythmic medications and without catheter ablation; and 2) symptom severity assessed by using a validated questionnaire. Results: By 12 months, freedom from AF was achieved in 24 (40%) of 60 patients in the exercise group and 12 (20%) of 60 patients in the control group (HR: 0.50: 95% CI: 0.33 to 0.78). At 6 months, AF symptom severity was lower in the exercise group compared with the control group (mean difference –2.3; 95% CI: –4.3 to –0.2; P = 0.033). This difference persisted at 12 months (–2.3; 95% CI: –4.5 to –0.1; P = 0.041). Total symptom burden was lower at 6 months in the exercise group but not at 12 months. Peak oxygen consumption was increased in the exercise group at both 6 and 12 months. There were no between-group differences in cardiac structure or function, body mass index, or blood pressure. Conclusions: Participation in an exercise-based intervention over 6 months reduced arrhythmia recurrence and improved symptom severity among patients with AF.
KW - arrhythmia
KW - cardiorespiratory fitness
KW - exercise
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=85151888410&partnerID=8YFLogxK
U2 - 10.1016/j.jacep.2022.12.002
DO - 10.1016/j.jacep.2022.12.002
M3 - Article
C2 - 36752479
AN - SCOPUS:85151888410
SN - 2405-500X
VL - 9
SP - 455
EP - 465
JO - JACC: Clinical Electrophysiology
JF - JACC: Clinical Electrophysiology
IS - 4
ER -