Kato M1, Ogano M2, Mori Y3, Kochi K3, Morimoto D3, Kadotani S3, Kito K3, Tabata M4, Kubo A1, Tanabe J2
1Tokoha University, Department of Shizuoka Physical Therapy, Faculty of Health Science, Shizuoka, Japan, 2Shizuoka Medical Center, Department of Cardiovascular Medicine, Shizuoka, Japan, 3Shizuoka Medical Center, Department of Rehabilitation, Shizuoka, Japan, 4Toyohashi SOZO University, School of Health Sciences, Toyohashi, Japan
Background: Atrial fibrillation (AF) is the most common sustained arrhythmia, associated with an increased risk of not only stroke and heart failure but also decline in physical function. In recent years, catheter ablation has emerged as an effective treatment for the restoration of sinus rhythm in patients with symptomatic, drug-refractory AF. Cardiac rehabilitation based on exercise training is considered a generally safe and effective treatment for improving health-related quality of life and exercise capacity following catheter ablation. However, it is not known whether cardiac rehabilitation improves cardiac and physical function in these patients.
Purpose: To assess the effect of cardiac rehabilitation on cardiac and physical function in patients treated with catheter ablation for persistent AF.
Methods: This was a single-centre, open-label, randomized controlled trial. Sixty-one patients treated with catheter ablation for persistent AF (86 % male; mean age = 65 ± 9 years) were randomly divided into two groups. Thirty patients underwent cardiac rehabilitation (cardiac rehabilitation group), while the remaining 31 patients received usual care (usual care group). Patients with a left ventricular ejection fraction (LVEF) 40 %; plasma brain natriuretic peptide level > 200 pg/mL; comorbidities related to neurological diseases, orthopaedic disorders, or dementia; or recurrence of AF within 1 month of undergoing catheter ablation were excluded from this study. Cardiac rehabilitation involved exercise training (endurance and resistance training) and nutrition consultations. Exercise training (supervised and unsupervised) was carried out more than three times per week for 6 months. LVEF, left atrial diameter (LAD), and the ratio of early mitral inflow velocity to mitral annular early diastolic velocity (E/e') were measured by echocardiogram as parameters of cardiac function. Hand grip strength, leg strength, and 6-minute walk distance (6MWD) were measured as parameters of physical function. We compared these parameters before and after the exercise period within and between the two groups.
Results: There were no significant differences in baseline characteristics between the 2 groups. None of the parameters changed significantly after the exercise period in the usual care group. The LVEF, hand grip strength, leg strength, and 6MWD increased significantly after the exercise period in the cardiac rehabilitation group compared with before (P 0.05, P 0.05, P 0.01, and P 0.01, respectively). No significant changes in LAD and E/e´ were observed before and after the exercise period in the control group.
Conclusion(s): This study demonstrated that cardiac rehabilitation improved LVEF, muscle strength, and 6MWD in patients treated with catheter ablation for persistent AF.
Implications: Cardiac rehabilitation may be recommended to patients treated with catheter ablation for persistent AF for disease management.
Keywords: Atrial fibrillation, catheter ablation, cardiac rehabilitation
Funding acknowledgements: This research was supported by JSPS KAKENHI grant number 18K17693.
Purpose: To assess the effect of cardiac rehabilitation on cardiac and physical function in patients treated with catheter ablation for persistent AF.
Methods: This was a single-centre, open-label, randomized controlled trial. Sixty-one patients treated with catheter ablation for persistent AF (86 % male; mean age = 65 ± 9 years) were randomly divided into two groups. Thirty patients underwent cardiac rehabilitation (cardiac rehabilitation group), while the remaining 31 patients received usual care (usual care group). Patients with a left ventricular ejection fraction (LVEF) 40 %; plasma brain natriuretic peptide level > 200 pg/mL; comorbidities related to neurological diseases, orthopaedic disorders, or dementia; or recurrence of AF within 1 month of undergoing catheter ablation were excluded from this study. Cardiac rehabilitation involved exercise training (endurance and resistance training) and nutrition consultations. Exercise training (supervised and unsupervised) was carried out more than three times per week for 6 months. LVEF, left atrial diameter (LAD), and the ratio of early mitral inflow velocity to mitral annular early diastolic velocity (E/e') were measured by echocardiogram as parameters of cardiac function. Hand grip strength, leg strength, and 6-minute walk distance (6MWD) were measured as parameters of physical function. We compared these parameters before and after the exercise period within and between the two groups.
Results: There were no significant differences in baseline characteristics between the 2 groups. None of the parameters changed significantly after the exercise period in the usual care group. The LVEF, hand grip strength, leg strength, and 6MWD increased significantly after the exercise period in the cardiac rehabilitation group compared with before (P 0.05, P 0.05, P 0.01, and P 0.01, respectively). No significant changes in LAD and E/e´ were observed before and after the exercise period in the control group.
Conclusion(s): This study demonstrated that cardiac rehabilitation improved LVEF, muscle strength, and 6MWD in patients treated with catheter ablation for persistent AF.
Implications: Cardiac rehabilitation may be recommended to patients treated with catheter ablation for persistent AF for disease management.
Keywords: Atrial fibrillation, catheter ablation, cardiac rehabilitation
Funding acknowledgements: This research was supported by JSPS KAKENHI grant number 18K17693.
Topic: Cardiorespiratory
Ethics approval required: Yes
Institution: Shizuoka Medical Center
Ethics committee: Ethics Committee of Shizuoka Medical Center
Ethics number: 26-17
All authors, affiliations and abstracts have been published as submitted.
