Effects of Exercise Training in Patients With Permanent Atrial Fibrillation

Effects of Exercise Training on Endothelial Function, Heart Rate Variability, Exercise Capacity, and Quality of Life in Patients With Permanent Atrial Fibrillation

Atrial fibrillation (AF) is a common arrhythmia. The proposed patholophysiological mechanisms of AF include abnormal electrical conduction in atrium and sympathovagal imbalance with increased vagal tone. Patients with AF have poor exercise capacity that may contribute to decreased atrial effective refractory period, and decreased cardiac output and heart rate reserve, and may result in poor quality of life. Poor endothelial function had been noted in patients with AF, associated with increased risks of cerebrovascular and cardiovascular disease. Exercise training has been noted to improve exercise capacity and quality of life in patients with AF only in some studies. Endothelial function can be improved by exercise training in patients with cardiovascular disease, but no report in patients with AF. Evidence of exercise training is still needed in patients with AF. The purpose of this study is to investigate the effect of exercise training on endothelial function heart rate variability exercise capacity quality of life.

A randomized controlled study was implemented to examine :(1) the effect of interval aerobic exercise training combined with resistance training on endothelial function, heart rate variability (HRV), exercise capacity, and quality of life (QoL); (2) the influential factors related to exercise capacity, and the relationship between exercise capacity and quality of life in patients with permanent atrial fibrillation (AF).

Atrial Fibrillation, Exercise Training, Endothelial Function, Autonomic Nerve Modulation, Exercise Capacity, Quality of Life

Exercise group will undergo progressively aerobic exercise training with 40-85% maximal oxygen consumption for 40 minutes, 3 sessions per week for 12 weeks.

Exercise group will undergo progressively aerobic exercise training with 40-85% maximal oxygen consumption for 40 minutes, 3 sessions per week for 12 weeks.

To measure maximal oxygen consumption, maximal oxygen pulse, maximal heart rate and blood pressure, cumulated and peak workload by cycle ergometer with Vmax 229 system

Subjects were tilted up 60 degree on tilting table for 15 minutes to record the change of blood pressure and heart rate, and heart rate variability.

To measure dependent-endothelial moulation by flow-mediated dilatation with Sonosite 180 portable ultrasound.

Inclusion Criteria: Permanent atrial fibrillation≥ 1 year aged 40-76 years Recurrence AF after ablation Under antiarrhythmia medication control Exclusion Criteria: CAD or myocardial infrarction history NYHA≥ III-IV, or LVEF≤45% Mitral or aortic valve regurgitation ≥ Gr. II Mitral valve or aortic valve stenosis Pacemaker Cardioversion by ablation Pulmonary artery hypertension Any surgery in previous 3 months Any neurological disorders Cancer Severe musculoskeletal disorder Hyperthyroidism Premenopausal women