Exercise Improves Atrial Fibrillation Outcomes

Exercise is beneficial to patients with atrial fibrillation (AF), according to the results of 2 recent studies.

The findings were presented at the American College of Cardiology’s 65th Annual Scientific Session & Expo on April 4, 2016.
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The studies were conducted to better understand how physical activity affects cardiovascular outcomes in patients with AF.

In the first study, the researchers analyzed data from 2442 patients with AF who were participating in the EURObservational Research Programme Pilot Survey on Atrial Fibrillation (EORP-AF) General Registry.

The researchers tracked cardiovascular events and risk factors and categorized patients based on their weekly physical activity level: none (38.9% of patients), occasional (34.7% of patients), regular (21.7% of patients), and intense (4.7% of patients).

After a 2-year follow-up, researchers found that those who reported regular and intense physical activity had decreased cardiovascular death, all-cause death, and composite outcomes. Risk factors progressively decreased from no physical activity to intense physical activity.

“AF patients taking regular exercise have a lower risk of all-cause death, regardless of gender, elderly age, clinical presentation, and stroke risk strata,” the researchers concluded. “Efforts to increase physical activity amongst AF patients may improve outcomes in these patients.”1

In the second study, the researchers aimed to compare the exercise capacity and mortality rate of patients with heart failure with preserved ejection fraction (HFpEF) with and without AF.

To conduct their study, researchers followed 1825 patients with HFpEF with and without AF and an ejection fraction of 50% or more who received a cardiopulmonary stress test at the Cleveland Clinic.

Each patient with AF (242) was matched with 2 patients without AF (484) based on clinical variables, ejection fraction, and medications.

After analyzing the data, the researchers found that mean peak VO2, oxygen pulse, and circulatory power were significantly lower and VE/VCO2 was higher in patients with AF. Patients with and without AF had similar peak heart rate, suggesting strict rate control.

“In this well-matched analysis of HFpEF patients, the largest of its kind, we demonstrate that AF is independently associated with exercise intolerance, impaired contractile reserve, and increased mortality,” the researchers concluded. “As such, rhythm control may be superior to rate control in HFpEF; a finding that requires further prospective evaluation.”2

—Amanda Balbi

References:

  1. Proietti M, Boriani G, Laroche C, et al. Physical activity and major adverse events in patients with atrial fibrillation: A report from the EURObservational research programme pilot survey on atrial fibrillation (EORP-AF) general registry. Paper presented at: 65th Annual Scientific Session & Expo; April 4, 2016; Chicago, IL. http://www.abstractsonline.com/pp8/#!/3874/presentation/42867.
  2. Elshazly MB, Wu Y, Saliba W, Wazni O, Cho L. The impact of atrial fibrillation on exercise capacity and mortality in heart failure with preserved ejection fraction: Insights from cardiopulmonary stress testing. Paper presented at: 65th Annual Scientific Session & Expo; April 4, 2016; Chicago, IL.  http://www.abstractsonline.com/pp8/#!/3874/presentation/42877.