In a new study from the University of Adelaide, researchers found a six-month exercise program helps maintain normal heart rhythm and reduces the severity of symptoms in patients with atrial fibrillation.
They found that some patients can control their arrhythmia through physical activity, without the need for complex interventions such as ablation or medications to keep their heart in normal rhythm.
Atrial fibrillation (AF) is a heart rhythm disorder that makes the heartbeat fast and irregularly.
The most common symptoms are palpitations, shortness of breath, lightheadedness, and fatigue, which can dramatically impact the quality of life. Patients have strong risks of stroke and heart failure.
Exercise-based rehabilitation is recommended for patients with coronary heart disease and heart failure, but few studies have examined the benefits in AF.
In one study, the team found that patients who gained cardio-respiratory fitness were much less likely to have recurrences of AF.
Another study showed that 12 weeks of aerobic interval training reduced the time spent in AF compared to usual care but the study enrolled just 51 patients and follow-up was only four weeks.
In the current study, the team assessed the impact of a six-month exercise program combining supervised and home-based aerobic exercise on AF recurrence and symptom severity.
The trial allocated 120 patients with symptomatic AF to an exercise intervention or usual care for six months.
The intervention included supervised exercise (weekly for three months then fortnightly for three months) and an individualized weekly plan to follow at home.
Over the six months, the target was to increase aerobic exercise up to 3.5 hours per week.
Supervised sessions were typically higher intensity to raise cardiorespiratory fitness, while home-based exercise was typically a moderate-intensity aerobic activity of the patient’s choice (e.g. walking, indoor cycling, swimming).
The usual care group received exercise advice but no active intervention. All patients received usual medical care from their cardiologist who was blinded to study group allocation.
The team found at 12 months, the AF recurrence rate was much lower in the exercise group (60%) compared to the control group (80%).
This means a larger number of patients in the exercise group could maintain a normal heart rhythm without needing invasive interventions or continued use of drugs.
Patients in the exercise group also had a big reduction in the severity of their symptoms at 12 months compared to the control group. This means that patients reported less severe palpitations, shortness of breath and fatigue.
This study provides evidence that aerobic exercise should be incorporated into the treatment of patients with symptomatic AF.
This should sit alongside the use of medications, as guided by a cardiologist, and management of obesity, hypertension and sleep apnea.
As a general guide, patients should strive to build up to 3.5 hours per week of aerobic exercise and incorporate some higher intensity activities to improve cardiorespiratory fitness.
If you care about heart health, please read studies about this simple exercise can strongly benefit people with heart problems and findings of doing exercise this way may strongly benefit your heart health.
For more information about heart disease, please see recent studies about timing of exercise linked to heart disease risk in people with type 2 diabetes and results showing that instant death from heart attack common in people who do not exercise.
The study was presented at ESC Congress 2021. One author of the study is Dr. Adrian Elliott.
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