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

94 Participants Needed

Trial Summary

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 data supports the effectiveness of this treatment for atrial fibrillation?

Research shows that high-intensity interval training (HIIT) can improve heart health, exercise capacity, and quality of life in people with atrial fibrillation. Studies also suggest that regular exercise can reduce symptoms and the recurrence of atrial fibrillation. ^{1 2 3 4 5}

Is exercise training safe for people with atrial fibrillation?

Exercise training, including high-intensity interval training and moderate-intensity continuous exercise, is generally safe for people with atrial fibrillation and can improve heart health, exercise capacity, and quality of life. ^{1 2 4 6 7}

How does exercise training differ from other treatments for atrial fibrillation?

Exercise training, particularly high-intensity interval training (HIIT), is unique because it focuses on improving functional capacity and quality of life in atrial fibrillation patients, which is not typically addressed by standard treatments. Unlike medications or surgical interventions, this approach uses physical activity to enhance heart health and reduce symptoms, offering a non-invasive option that can be personalized to individual needs. ^{1 2 5 8 9}

What is the purpose of this trial?

Atrial fibrillation is the most common heart rhythm disorder. The management of atrial fibrillation is of great importance. Despite the presence of exercise intolerance, weight gain, and an associated decline in overall health and well-being in patients living with atrial fibrillation, recommended standard care does not currently include the prescription of exercise to address these significant health issues. Exercise training is a recognized form of treatment of persons with heart disease. An exercise program such as high-intensity interval training when compared to moderate-intensity continuous exercise training may provide a stronger training stimulus for exercise and clinical outcomes; may be more efficient and motivating; and, may help to improve adherence to exercise training in persistent or permanent atrial fibrillation patients. This has been shown in patients with coronary artery disease and heart failure. The primary objectives of this prospective study are to examine the impact of high-intensity interval training compared to moderate-intensity continuous exercise training in adults with persistent or permanent atrial fibrillation on exercise capacity and quality of life.

Research Team

Jennifer L Reed, PhD

Principal Investigator

Ottawa Heart Institute Research Corporation

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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 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]

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]

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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Effect of High-Intensity Interval Training in Patients With Atrial Fibrillation: A Randomized Clinical Trial. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Aerobic Interval Training Reduces the Burden of Atrial Fibrillation in the Short Term: A Randomized Trial. [2022]

3. England 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. [2023]

4. Canada 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. [2018]

5. Switzerland pubmed.ncbi.nlm.nih.gov

Atrial Fibrillation Specific Exercise Rehabilitation: Are We There Yet? [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Cardiovascular exercise and burden of arrhythmia in patients with atrial fibrillation - A randomized controlled trial. [2020]

7. United States pubmed.ncbi.nlm.nih.gov

Exercise training in heart failure with reduced ejection fraction and permanent atrial fibrillation: A randomized clinical trial. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Exercise performance and training in cardiac patients with atrial fibrillation. [2019]

9. Sweden 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. [2015]