A new analysis of clinical studies finds that exercise-based cardiac rehabilitation can reduce the symptoms, frequency, and recurrence of atrial fibrillation (AF), a common type of irregular heartbeat.
It also helps people improve their fitness and mental health, all without serious side effects.
AF happens when the top chambers of the heart (atria) beat irregularly, causing problems with blood flow to the bottom chambers (ventricles).
This can lead to symptoms like heart palpitations, chest pain, tiredness, dizziness, and shortness of breath. AF increases the risk of stroke and heart failure. Millions of people in the US and Europe are expected to develop AF in the coming decades.
While medications and procedures are available, this research highlights how lifestyle changes like exercise can also play a key role.
Cardiac rehab typically includes physical exercise, health education, psychological support, and lifestyle coaching. Although this rehab is widely used for heart attack and heart failure patients, its benefits for people with AF weren’t previously clear.
Researchers reviewed 20 studies conducted between 2006 and 2024 involving over 2,000 people with AF. The programs lasted 8 to 24 weeks with weekly sessions of 15 to 90 minutes.
Some included only exercise, while others combined exercise with education or psychological support. Most focused on moderate aerobic exercise; a few included resistance training.
The results showed that cardiac rehab reduced AF symptom severity by 39%, the frequency and duration of episodes by over 40%, and the risk of recurrence by 32%. It also improved exercise capacity and mental health scores. Importantly, there was no increase in deaths or serious side effects.
These benefits were seen regardless of age, AF type, or how the rehab was delivered. While some studies had limitations—such as small size or short follow-up—the overall evidence was strong. The researchers suggest that physical and psychological improvements from exercise may help reduce the burden of AF.
An editorial by heart experts in London supports these findings. They emphasize that exercise is one of the most cost-effective and widely available treatments for heart conditions. Although some patients worry that exercise might trigger AF, moderate activity is generally safe. However, programs should be personalized to each patient’s needs.
The researchers recommend updating medical guidelines to include exercise-based cardiac rehab as a standard treatment for people with AF, alongside medication and medical procedures.
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The study is published in British Journal of Sports Medicine.
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