Regular exercise helps reduce the severity of symptoms of the heart condition atrial fibrillation and allows patients to maintain normal heart rhythm, according to a new study that found physical activity may often negate the need for other interventions.
The research, presented at this week’s European Society of Cardiology Congress, found exercise-based rehabilitation to be an efficient and cost-effective way to treat the disorder that causes the heart to beat more quickly and irregularly. “The ACTIVE-AF trial demonstrates that some patients can control their arrhythmia through physical activity, without the need for complex interventions such as ablation or medications to keep their heart in normal rhythm,” said Adrian Elliott, the author of the study at the University of Adelaide in Australia.
Atrial fibrillation, also known as AF or Afib, is caused by disturbances in heart’s electrical signal, according to the Heart and Stroke Foundation. The risk of developing the condition, which affects roughly 200,000 Canadians, increases with age and the presence of other risk factors, including diabetes, heart disease and elevated blood pressure. Global rates of AF are believed to be in the range of 30 million people, according to the study, with the lifetime risk as high as one in three in people over 55 years of age.
While previous research has established the benefits of exercise on overall heart health, few have delved into its potential to help people with AF specifically. The ACTIVE-AF trial employed by researchers attempted to address this omission by testing the effects of a six-month exercise program, and six months of follow-up, on the recurrence rate and symptom severity of AF. Patients who suffer from short bouts of atrial fibrillation (paroxysmal AF) and longer bouts requiring intervention (persistent AF) were included but those whose normal heart rhythm cannot be corrected (permanent AF) were left out.
One hundred and twenty symptomatic AF patients (43 per cent female; average age 65) were randomly assigned to one of two groups for six months: the exercise intervention or their usual routine. The intervention group was required to perform higher intensity supervised exercise once a week for three months, once every two weeks for three months and then an individually tailored home routine of moderate difficulty. The control group received advice on exercise but no specific program to complete. They all received standard care from cardiologists who were unaware of group allocation.
Recurrent AF was defined as episodes that persist for longer than 30 seconds or those requiring drug therapy or an ablation intervention. At the 12-month mark, the recurrence of AF in the intervention group was 60 per cent — significantly lower than the 80 per cent experienced by the control group.
“Put simply, this means a larger number of patients in the exercise group could maintain a normal heart rhythm without needing invasive interventions or continued use of drugs,” Elliot said.
This group also experienced less severe symptoms of AF over the same period of time. “This means that patients reported less severe palpitations, shortness of breath and fatigue,” Elliot said.
“Our study provides evidence that aerobic exercise should be incorporated into the treatment of patients with symptomatic AF. This should sit alongside the use of medications, as guided by a cardiologist, and management of obesity, hypertension and sleep apnea. As a general guide, patients should strive to build up to 3.5 hours per week of aerobic exercise and incorporate some higher intensity activities to improve cardiorespiratory fitness.”
Dave Yasvinski is a writer with Healthing.ca