Effects of concurrent training on atrial fibrillation burden, fitness and physical activity after pulmonary vein...

Pulmonary vein isolation (PVI) is an effective treatment for atrial fibrillation (AF), but many patients remain inactive after the procedure for fear of AF recurrence. Evidence supports moderate exercise to improve outcomes of this procedure; however, there are no clear guidelines for returning to physical exercise after PVI. We aim to evaluate the effects of a combined endurance and resistance training (CT) intervention on cardiac function, physical fitness, activity levels, body composition, quality of life, and AF burden after PVI.

We will conduct a randomized controlled trial with 68 participants, approximately 15 months after PVI, randomized 1:1 to a CT or control group. The CT program consists of supervised training sessions combining moderate-intensity endurance and resistance work three times a week for 12 weeks. Outcomes will be assessed at three time points: at baseline, after the intervention, and after 12 weeks of follow-up, including echocardiographic and electrocardiographic parameters, fitness tests, physical activity monitoring, body composition, health-related quality of life, and AF burden monitored by an implantable cardiac Holter. We expect that CT intervention will improve cardiac function, increase physical fitness and activity levels, optimize body composition, and improve quality of life without recurrence of AF.

This protocol is the first to examine the effects of return to exercise training in AF patients after PVI using objective monitoring tools. The simplicity and scalability of the intervention support its safe integration into clinical practice to promote physical activity and improve patient outcomes after PVI.