February 9, 2017ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam)
Exercise-based cardiac rehabilitation for adults with atrial fibrillation
Why the study?
Does exercise-based cardiac rehabilitation improve outcomes in adults with atrial fibrillation?
Population
6 RCTs pooling 421 adults with various types of atrial fibrillation, or post-treatment for atrial…
Comparison
Exercise-based rehabilitation programmes vs No-exercise training controls
Design
Meta-analysis
Follow-up
eight weeks to six months
Authors
Discussion
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Implication
Supports exercise-based rehab to boost capacity in AF without raising mortality risk; extends cardiac rehab evidence but leaves hard outcomes open.
Key Points
- To assess the benefits and harms of exercise-based cardiac rehabilitation programs compared with no-exercise controls in adults with current or treated atrial fibrillation.
- Systematic review and meta-analysis of 6 randomized controlled trials (N=421) examining adults aged 18 years or older with atrial fibrillation or post-treatment AF.
- Interventions evaluated included aerobic and resistance training (4 trials), Qi-gong (1 trial), and inspiratory muscle training (1 trial) versus no exercise, with follow-up durations between 8 weeks and 6 months.
- Methodological quality and evidence certainty were appraised using the Cochrane Risk of Bias tool, Trial Sequential Analysis, and GRADE methodology.
- Exercise-based rehabilitation showed no clear difference in all-cause mortality (RR 1.00, 95% CI 0.06 to 15.78; 2 deaths; N=421) or serious adverse events (RR 1.01, 95% CI 0.98 to 1.05; 8 events; N=381).
- No clinically relevant differences were identified for health-related quality of life on the SF-36 physical component (MD 1.96, 95% CI -2.50 to 6.42; N=224) or mental component summary (MD 1.99, 95% CI -0.48 to 4.46; N=224).
- Exercise rehabilitation significantly improved functional capacity, evidenced by higher VO2 peak (MD 3.76, 95% CI 1.37 to 6.15; N=208), greater six-minute walk distance (MD 75.76 m, 95% CI 14.00 to 137.53; N=272), and pooled exercise capacity (SMD 0.86, 95% CI 0.46 to 1.26; N=359).
Structured PICO
Does exercise-based cardiac rehabilitation improve outcomes in adults with atrial fibrillation?
P
Population
6 RCTs pooling 421 adults (aged 18 years or older) with various types of atrial fibrillation, or post-treatment for atrial fibrillation.
I
Intervention
Exercise-based rehabilitation programmes (including aerobic exercise and resistance training, Qi-gong, or inspiratory muscle training)
C
Comparator
No-exercise training controls
O
Outcome
Mortality, serious adverse events, health-related quality of life, and exercise capacity
Exercise-based cardiac rehabilitation improves physical exercise capacity in patients with atrial fibrillation, though its impact on mortality and quality of life remains uncertain due to low-quality evidence.
Limitations
- Few randomised patients and outcomes
- Short follow-up (8 weeks to 6 months)
- Moderate to very low-quality evidence
Cite This Study
Risom et al. (2017) studied this question.