Exercise Training for Atrial Fibrillation

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Ottawa Heart Institute Research Corporation

Disqualifiers: Routine exercise, Unstable angina, Uncontrolled diabetes, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests different exercise programs to help people with atrial fibrillation, a common heart rhythm problem, improve their fitness and quality of life. It compares high-intensity interval training (short bursts of hard exercise) with moderate-intensity continuous exercise (steady, moderate exercise). The goal is to determine which type of exercise better manages symptoms and improves health. Adults who have had atrial fibrillation for a while and can complete an exercise test without symptoms might be a good fit, especially if they are not already exercising regularly. As an unphased trial, this study offers a unique opportunity to explore personalized exercise strategies to enhance well-being.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.

What prior data suggests that these exercise training methods are safe for adults with atrial fibrillation?

Research has shown that both high-intensity interval training (HIIT) and moderate-intensity continuous exercise training (MICT) are safe for individuals with atrial fibrillation. Participants in studies handled both exercise types well, with no serious side effects reported. Over a year, those engaging in either HIIT or MICT showed similar improvements in fitness levels.

HIIT can help reduce atrial fibrillation symptoms and might lower the risk of developing it. However, there is a small chance it could cause heart changes that might increase atrial fibrillation. MICT also offers benefits, such as improving heart health and reducing heart strain, which can lessen atrial fibrillation. Both exercise methods are generally safe, but consulting a healthcare provider before starting a new exercise routine is advisable. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these exercise methods for atrial fibrillation (AF) because they offer a non-invasive approach to managing the condition. Most treatments for AF, like medications or procedures such as cardioversion and ablation, focus on directly altering heart rhythms or structures. In contrast, high-intensity interval training and moderate-intensity continuous exercise could improve heart health and reduce AF symptoms by enhancing cardiovascular fitness and reducing inflammation naturally. This approach not only promotes overall wellness but might also lower the need for medication or invasive procedures, making it an attractive option for many patients.

What evidence suggests that this trial's exercise training treatments could be effective for atrial fibrillation?

This trial will compare high-intensity interval training (HIIT) with moderate-intensity continuous exercise training (MICT) for managing atrial fibrillation (AF). Research has shown that HIIT can greatly reduce AF symptoms, boost fitness levels, and improve quality of life. Studies suggest that HIIT might be more effective than other exercise types in lessening AF symptoms over time and is associated with better long-term fitness. In contrast, MICT has been found to improve heart health and reduce heart tissue damage, which can lower the frequency of AF episodes and improve symptoms. Both HIIT and MICT offer valuable benefits for managing AF, each with its own advantages. ^{1 2 4 6 7}

Who Is on the Research Team?

Jennifer L Reed, PhD

Principal Investigator

Ottawa Heart Institute Research Corporation

Are You a Good Fit for This Trial?

This trial is for adults over 40 with persistent or permanent atrial fibrillation, a resting heart rate of 110 bpm or less, and able to do an exercise test. They must not be already exercising regularly, have unstable angina, certain heart conditions like obstructive cardiomyopathy or severe valve stenosis, uncontrolled diabetes, and must agree to sign informed consent.

Inclusion Criteria

I am 40 years old or older.

I have ongoing or permanent irregular heartbeat.

You can do a test where you exercise until you feel a symptom.

Exclusion Criteria

My diabetes is not well-managed.

I have been diagnosed with severe narrowing of my heart's mitral or aortic valve.

I have been diagnosed with a thickened heart muscle that obstructs blood flow.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo either high-intensity interval training or moderate-intensity continuous exercise training

12 weeks

Regular exercise sessions

Follow-up

Participants are monitored for changes in quality of life and exercise capacity

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• high-intensity interval training
• moderate-intensity continuous exercise training

Trial Overview The study compares two types of exercise programs for people with atrial fibrillation: high-intensity interval training (short bursts of intense activity) versus moderate-intensity continuous training (steady activity). It aims to see which one better improves exercise capacity and quality of life.

How Is the Trial Designed?

Group I: Moderate-intensity continuous exercise Experimental Treatment 1 Intervention

Moderate-intensity continuous exercise training

Group II: High-Intensity Interval Training Experimental Treatment 1 Intervention

High-Intensity Interval Training

Who Is Running the Clinical Trial?

Ottawa Heart Institute Research Corporation

Lead Sponsor

Trials

200

Recruited

95,800+

Published Research Related to This Trial

A 74-year-old man with permanent atrial fibrillation showed significant health improvements after a 10-week high-intensity interval training program, including better heart rate, blood pressure, and aerobic capacity.

This case suggests that high-intensity interval training may be a beneficial non-pharmacological intervention for patients with permanent atrial fibrillation, especially since they often lack other treatment options.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-intensity interval training improves cardiovascular health, exercise capacity, and quality of life in permanent atrial fibrillation: a case study. Reed, JL., Nery, PB., Birnie, DH., et al.[2018]

A 12-week study involving 94 patients with persistent and permanent atrial fibrillation found that high-intensity interval training (HIIT) was as effective as continuous aerobic training (CR) in improving functional capacity and quality of life.

Both HIIT and CR showed similar outcomes in terms of disease-specific quality of life, resting heart rate, and physical activity levels, indicating that shorter, more intense workouts can be a viable alternative to longer, moderate-intensity training for these patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of High-Intensity Interval Training in Patients With Atrial Fibrillation: A Randomized Clinical Trial. Reed, JL., Terada, T., Vidal-Almela, S., et al.[2022]

Regular physical activity, specifically 360-720 MET-minutes per week (about 60-120 minutes of moderate-to-vigorous exercise), is recommended for patients with atrial fibrillation (AF) to improve outcomes and quality of life, based on data from 21 studies.

Incorporating non-traditional exercises like Yoga into rehabilitation programs may enhance quality of life for AF patients, highlighting the need for personalized exercise plans in their care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Atrial Fibrillation Specific Exercise Rehabilitation: Are We There Yet? Buckley, BJR., Risom, SS., Boidin, M., et al.[2022]

Aerobic interval training (AIT) for 12 weeks significantly reduced the time patients spent in atrial fibrillation (AF) from 8.1% to 4.8%, while the control group experienced an increase from 10.4% to 14.6%.

AIT also led to improvements in AF symptoms, cardiovascular health (including peak oxygen uptake and heart function), lipid levels, and overall quality of life, indicating its efficacy as a treatment for patients with nonpermanent AF.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Aerobic Interval Training Reduces the Burden of Atrial Fibrillation in the Short Term: A Randomized Trial. Malmo, V., Nes, BM., Amundsen, BH., et al.[2022]

In a study of 49 patients with permanent atrial fibrillation, a 12-week aerobic exercise program significantly improved muscle strength, exercise capacity, and quality of life compared to a control group.

The training group showed notable enhancements in exercise capacity (p < 0.001) and quality of life scores, particularly in physical functioning and general health perceptions, while lean body mass remained unchanged.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of physical exercise training on muscle strength and body composition, and their association with functional capacity and quality of life in patients with atrial fibrillation: a randomized controlled trial. Osbak, PS., Mourier, M., Henriksen, JH., et al.[2015]

In a study of 120 patients with symptomatic atrial fibrillation, a 6-month exercise intervention significantly reduced the recurrence of arrhythmia for both men and women, with hazard ratios indicating a protective effect for both sexes.

Women in the exercise group experienced a notable reduction in symptom severity scores at 12 months, while no significant change was observed in men, suggesting that exercise may have a more pronounced benefit for women in managing symptoms of atrial fibrillation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Influence of Sex on Efficacy of Exercise Training for Patients with Symptomatic Atrial Fibrillation: Insights from the ACTIVE-AF Randomised Controlled Trial. Verdicchio, CV., Mahajan, R., Middeldorp, ME., et al.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9623436/

Effect of High-Intensity Interval Training in Patients With ... A decrease in the Atrial Fibrillation Severity Scale symptom scores was observed over time following HIIT and CR. Systematic reviews have noted ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S1050173824000021

Effects of different exercise methods and intensities on the ... High-intensity interval training (HIIT) shows promise, potentially surpassing MICT, especially in reducing age-related AF susceptibility and improving symptoms ...

3. academic.oup.com academic.oup.com/eurjpc/article/32/Supplement_1/zwaf236.169/8136817

The long-term effects of high-intensity interval training on ... Our findings indicate that HIIT-based CR led to a statistically greater functional capacity sustainability over a 2-year period, with mean ...

4. gavinpublishers.com gavinpublishers.com/article/view/the-application-of-high-intensity-interval--training-in-atrial-fibrillation-a-literature-review

The Application of High Intensity Interval Training in Atrial ... The findings of these studies reveal promising outcomes related to reduced AF symptoms severity, improved aerobic capacity, quality of life and ...

5. ahajournals.org ahajournals.org/doi/10.1161/circep.117.005598

Does High-Intensity Endurance Training Increase the Risk ... Regular high-intensity aerobic exercise may lead to left atrial structural and mechanical changes such as increased left atrial volumes during the 10-month ...

6. jamanetwork.com jamanetwork.com/journals/jamacardiology/fullarticle/2769884

Short-term and Long-term Feasibility, Safety, and Efficacy ... Over 12 months, both HIIT and MICT were safe and feasible and offered similar improvements in cardiorespiratory fitness (by 10% and 7%, ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10776210/

Exercise and Atrial Fibrillation: The Dose Makes the Poison ... showed a reduction of paroxysmal AF-load between 4 and 8% in patients undergoing high-intensity interval training twice a week compared to standard care. Most ...