Key result
A 3-month cardiac rehabilitation program significantly increased the proportion of successfully physically active patients from 67% at baseline to 86% at 1 year in patients with persistent AF and HF.
Why the study?
Physical inactivity is associated with increased AF prevalence, but whether cardiac rehabilitation motivates sustained physical activity and affects sinus rhythm maintenance and quality of life in persistent AF and moderate heart failure was unproven.
Does a 3-month cardiac rehabilitation program improve physical activity, sinus rhythm maintenance, and quality of life in patients with persistent AF and moderate heart failure?
Cohort (n=119)
Open-label
Yes
Does a 3-month cardiac rehabilitation program improve physical activity, sinus rhythm maintenance, and quality of life in patients with persistent AF and moderate heart failure?
Absolute Event Rate: 86% vs 67%
p-value: p=0.001
A 3-month cardiac rehabilitation program improves and maintains physical activity in patients with persistent AF and moderate heart failure, though without apparent benefits on sinus rhythm maintenance or quality of life.
May support cardiac rehabilitation for physical activity maintenance in persistent AF with HF; hypothesis-generating without randomized confirmation.
BACKGROUND AND AIM: Physical inactivity is associated with an increased prevalence of atrial fibrillation (AF). We aim to evaluate whether cardiac rehabilitation (CR) motivates patients to become and stay physical active, and whether CR affects sinus rhythm maintenance and quality of life (QoL) in patients with persistent AF and moderate heart failure. METHODS: In the Routine versus Aggressive risk factor driven upstream rhythm Control for prevention of Early atrial fibrillation in heart failure study patients were randomized to conventional or targeted therapy. Targeted therapy contained next to optimal risk factor management a 3-month CR program, including self-reported physical activity and counseling. Successful physical activity was assessed in the targeted group, defined as activity of moderate intensity ≥ 150 min/week, or ≥ 75 min/week of vigorous intensity. AF was assessed at 1 year on 7-days Holter monitoring, QoL using general health, fatigue and AF symptom questionnaires. RESULTS: All 119 patients within the targeted group participated in the CR program, 106 (89%) completed it. At baseline 80 (67%) patients were successfully physical active, 39 (33%) were not. NTproBNP was lower in active patients. During 1-year follow-up physical active patients stayed active: 72 (90%) at 12 weeks, 72 (90%) at 1 year. Inactive patients became active: at 12 weeks 25 (64%) patients and 30 (77%) at 1 year. No benefits were seen on sinus rhythm maintenance and QoL for successful physical active patients. CONCLUSION: In patients with persistent AF and moderate heart failure participation in CR contributes to improve and to maintain physical activity.
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Nguyen et al. (2020) conducted a cohort in Atrial Fibrillation and Heart Failure (n=119). Cardiac rehabilitation program vs. Baseline (pre-intervention) was evaluated on Achievement of successful physical activity at 1 year (p=0.001). A 3-month cardiac rehabilitation program significantly increased the proportion of successfully physically active patients from 67% at baseline to 86% at 1 year in patients with persistent AF and HF.