The role and outcome of cardiac rehabilitation program in patients with atrial fibrillation

Abstract

Background Atrial fibrillation (AF) is associated with diminished cardiac function, and exercise tolerance. Hypothesis We sought to investigate the role of cardiac rehabilitation program (CR) in patients with AF. Methods The study included 2165 consecutive patients that participated in our CR program between the years 2009 to 2015. All were evaluated by a standard exercise stress test (EST) at baseline, and upon completion of at least 3 months of training. Participants were dichotomized according to baseline fitness and the degree of functional improvement. The combined primary end point was cardiac related hospitalization or all‐cause mortality. Results A total of 292 patients had history of AF, with a mean age of 68 ± 9 years old, 76% of which were males. The median predicted baseline fitness of AF patients was significantly lower compared to non‐AF patients (103% vs 122%, P < 0.001, respectively). Prominent improvement was achieved in the majority of the patients in both groups (64% among AF patients and 63% among those without AF). Median improvement in fitness between stress tests was significantly higher in patients with AF (124% vs 110%, P < 0.001, respectively). Among AF patients, high baseline fitness was associated with a lower event rates (HR 0.40; 95%CI 0.23‐0.70; P = 0.001). Moreover, prominent improvement during CR showed a protective effect (HR 0.83; 95% CI 0.69‐0.99; P = 0.04). Conclusion In patients with AF participating in CR program, low fitness levels at baseline EST are associated with increased risk of total mortality or cardiovascular hospitalization during long‐term follow‐up. Improvement on follow‐up EST diminishes the risk.

Association of income and educational attainment in hospitalization events in atrial fibrillation

“…More research is needed to target interventions for high- patients, thereby addressing disparities. Targeted rehabilitation programs, including group education and physical training for patients with AF, significantly diminished the risk of mortality and cardiovascular hospitalizations [ 39 , 40 ]. These structured care programs have enhanced patient outcomes among patients with AF Reinforced, targeted, in-person education can improve quality of life, symptoms improvement, and medication adherence [41] .…”

Effect of patient education and physical training on quality of life and physical exercise capacity in patients with paroxysmal or persistent atrial fibrillation: A randomized study

“…Recent studies have compared AF patients and non-AF patients who joined a cardiac rehabilitation programme for other cardiovascular diseases or cardiovascular risk factors. Younis et al found that patients with AF initially had lower physical capacity than non-AF participants, but improvement in physical capacity diminished the risk of total mortality and cardiovascular hospitalization for both groups (27). In a case control study Reed et al found that rehabilitation improved QoL in both groups, but to a greater extent in patients without AF (28).…”

Clinical efficacy of a personalized exercise program in the rehabilitation of patients with atrial fibrillation after radiofrequency ablation

“…В исследовании Osbak PS, et al (2012) у больных (n=49) с ФП после 12-мес. курса ФТ (на велотренажере с интенсивностью 70% от максимальной мощности в течение 30 мин, в виде степ-нагрузки и бега с напряжением 14-16 баллов по шкале Борга) мощность нагрузки при ВЭМ-пробе возрастала на 8,8% (р<0,001) и ЧСС в покое уменьшилась на 9,1% (р=0,049) [13] [15]. С ростом параметров ФРС связывают и лучший контроль основных факторов риска у пациентов с ФП при разной стратегии контроля ритма сердца в реабилитационных программах [16].…”