Exercise performance and training in cardiac patients with atrial fibrillation

Exercise training in cardiac patients with chronic atrial fibrillation (AF) has received little attention in the literature. Therefore, this study compared exercise performance and the effect of an exercise training program over a period of 3 months in patients with and without AF.

Data in patients with AF (n = 19) were compared with a control group of patients in sinus rhythm (n = 44), drawn from a database of 2,116 patients. Patients performed a maximal exercise test on the bicycle until exhaustion before and after an ambulatory exercise training program where exercise training was offered 3 times a week for 3 months.

Before training, peak oxygen uptake (VO2) was significantly lower in patients with AF compared with the control group (1271 +/- 368 versus 1496 +/- 414 mL/min, P < 0.05). Exercise training significantly increased peak VO2 in both groups (+31%, P < 0.001 in AF and +25%, P < 0.001 in the control group). The gain in peak VO2 did not significantly differ between both groups. A significant decrease in resting heart rate was achieved in both groups after exercise training. AF was also a significant and independent determinant of peak VO2 in the total database, but not of the change in peak VO2.

Exercise training significantly improves exercise performance in cardiac patients with AF. AF affects exercise performance but does not impair the beneficial effects of training. Patients with chronic AF should therefore not be dissuaded from participating in exercise training after a cardiac event.