Kinesiophobia After Atrial Fibrillation Ablation: Associated Risk Factors and Impacts on Postprocedural Syndrome

Exercise-based cardiac rehabilitation (CR) after atrial fibrillation (AF) ablation is beneficial for patients with AF; however, kinesiophobia has been demonstrated to be a significant barrier to CR. The aim of the study was to investigate the perioperative risk factors for kinesiophobia, as well as its impact on postprocedural syndrome after AF ablation. Consecutive patients with paroxysmal AF who underwent ablation between January 2023 and April 2023 were included. Kinesiophobia and exercise self-efficacy were assessed 48 to 72 hours after ablation. Scheduled follow-up was conducted 1, 2, 3, and 6 months after the procedure. Among the 87 patients enrolled, 54 (62%) suffered from a high level of postoperative kinesiophobia. Patients with kinesiophobia were more likely to suffer from postoperative nonspecific symptoms (P < .001) and decreased exercise tolerance (P < .001) during early recovery period. The anesthesia method (OR = 0.05: 95% CI, 0.01-0.17) and preoperative European Heart Rhythm Association (EHRA) score (OR = 6.60: 95% CI, 1.85-26.95) were important risk factors for postoperative kinesiophobia. The anesthesia method and preoperative EHRA score were associated with nonspecific symptoms and decreased exercise tolerance, which is fully mediated by kinesiophobia. Kinesiophobia was significantly correlated with adverse experiences during the early recovery period after AF ablation. The choice of anesthesia, management of AF-related symptoms, and patient education are crucial for reducing kinesiophobia.