Efficacy of Exercise Rehabilitation in Patients with Atrial Fibrillation after Radiofrequency Ablation: A Meta-Analysis of Randomized Controlled Trials

Abstract

Background and Aims. Radiofrequency ablation is a commonly used treatment for paroxysmal atrial fibrillation (AF), but postoperative rehabilitation exercises are needed to reverse left ventricular structural and functional abnormalities. This meta-analysis aimed to evaluate the intervention effect of exercise training in patients with AF after radiofrequency ablation. Methods. A systematic literature search was conducted to identify articles in PubMed, MEDLINE, EMBASE, and the Cochrane Library from January 1, 2010 to December 1, 2021. The mean difference with 95% CI was pooled for continuous variables. We used Review Manager 5.3 for the standard meta-analysis. This study followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results. Ten randomized controlled trials (RCTs) were included, with a total of 892 patients with AF. The quality of one study was grade A, and the rest were grade B. The results of the meta-analysis showed that the improvement of 6 min walking distance (MD = 34.42, 95% CI: 3.20 to 65.63, P = 0.03 ), peak oxygen uptake (MD = 1.96, 95% CI: 1.14 to 2.78, P < 0.001 ), left ventricular ejection fraction (LVEF) (MD = 0.09, 95% CI:0.01–0.17, P = 0.02 ), resting heart rate (MD = −4.50, 95% CI: −8.85 to −0.14, P = 0.04 ), and physical component summary (PCS) (MD = 3.00, 95% CI: 0.46 to 5.54, P = 0.02 ) in the experimental group was significantly better than that of the control group, and the difference was statistically significant. Conclusion. Exercise training can improve the level of exercise endurance and cardiac function in patients. However, the results were limited by the quantity and quality of the studies. Large samples and high-quality studies are still needed to verify its long-term efficacy.

Safety and Effectiveness of Exercise-Based Cardiac Rehabilitation for Patients With Atrial Fibrillation Following Radiofrequency Catheter Ablation Therapy: A Systematic Review and Meta-Analysis

“…As for the effect of CR on patient cardiac function after RCFA, CR may not affect LVEF. This result was contrary to a previous systematic review [ 23 ], which revealed a small effect, with an MD of 0.09 (95%CI 0.01, 0.17). While other reports have indicated improved LVEF in patients with heart failure following CR, the studies included in our analysis [ 36 , 38 , 42 ] reported normal baseline LVEF values.…”

“…However, the results are uncertain because fewer than three studies were included in that review, and exercise intensity was not standardized. Another systematic review also examined CR's effect on patients after RFCA [ 23 ], but safety was not discussed, and the included papers found non-directiveness. Thus, this systematic review aimed to examine the AF recurrence associated with moderate exercise-based CR in patients with AF after RFCA, as well as with exercise function and cardiac function.…”

Efficacy of physical exercise on the physical ability, cardiac function and cardiopulmonary fitness of patients with atrial fibrillation: a systematic review and meta-analysis

“…Forest plot shows the ES of physical exercise on peak vo2 in AF patients. Compared with the previous analysis (8,9), our study included more types of patients with AF, such as patients with AF after radiofrequency ablation and patients with heart failure with AF (10,16,18,19,23). The reason why we do so is mainly to consider that the clinical condition of some AF patients is more complex.…”

“…Fewer types of AF patients were included in the study (8,9), and the effect of exercise on cardiac function in patients with AF is unclear despite previous meta-analyses in this area. After searching relevant experiments, we found some controversy about whether exercise can improve the LVEF in patients with atrial fibrillation.…”

The Application of High Intensity Interval Training in Atrial Fibrillation: A Literature Review

“…Nevertheless, the latest report from the European Society of Cardiology on AF management highlights the importance of encouraging patients with AF to engage in moderate-intensity exercise and maintain physical activity levels to reduce the risk of AF [8]. Data from systematic reviews and meta-analyses have reported substantial improvements in cardiovascular capacity and quality of life for individuals with AF who underwent cardiac rehabilitation [13][14][15][16]. However, the research on exercise training for AF patients has employed diverse protocols, underscoring the lack of clear consensus regarding the exact exercise recommendations for individuals with AF, in contrast to other cardiovascular diagnosis.…”