Exercise‐based cardiac rehabilitation improves physical fitness in patients with permanent atrial fibrillation – A randomized controlled study

Abstract

The aim of this multicenter randomized controlled trial was to compare physiotherapist-led exercise-based cardiac rehabilitation (PT-X) with physical activity on prescription (PAP) with regard to physical fitness, physical activity, health-related quality of life (HR-QoL), and metabolic risk markers in patients with permanent atrial fibrillation. Ninety six patients (28 women), age 74 (5) years, and ejection fraction ≥45% were randomized. An exercise tolerance test (primary outcome measure), muscle endurance tests, HR-QoL, physical activity assessments (questionnaire and accelerometer), and blood sampling were performed. The PT-X consisted of 60-minute group sessions and home-based exercise, both twice a week. The PAP consisted of 40 minutes of active walking, 4 times a week. Eighty seven patients completed the study. Exercise tolerance (maximum exercise capacity) improved significantly after PT-X (n = 40) but not after PAP (n = 47) (16 vs −3 W; P < .0001). Muscle endurance also improved after PT-X: shoulder flexion left arm (7 vs −1 repetition; P < .001), heel-lift right leg (4 vs 1 repetition; P < .05), left leg (4 vs −1 repetition; P < .001), and shoulder abduction (17 vs −4 s; P < .010). PAP significantly increased energy expenditure. Health-related quality of life and lab-tests did not differ. PT-X improved physical fitness in patients with permanent atrial fibrillation.