Impact of physical activity on atrial fibrillation recurrence following catheter ablation

Atrial fibrillation (AF) is a widely prevalent arrhythmia associated with significant morbidity and mortality. Despite advances in catheter ablation (CA), long-term arrhythmia-free survival rates are suboptimal. While prior studies have demonstrated the cardiovascular benefits of exercise, its effects on AF recurrence following CA have yet to be elucidated.

We performed a chart review of consecutive patients who underwent first-time CA for AF and interviewed them to determine average weekly levels of physical activity and assessed the risk of AF recurrence in relation to weekly exercise intensity and duration.

We included 163 patients with mean age of 69.3 ± 10.9 years, 39.8% were women and CHA₂DS₂-VASc was 3.24 ± 1.8. Of the 163 patients, 114 (70%) participated in more than 90 mins of weekly moderate physical activity (MPA). Patients participating in more than 90 weekly minutes of MPA had lower risk of AF recurrence compared with less than 90 weekly minutes (hazard ratio [HR]: 0.54, 95% confidence interval [CI] 0.31 to 0.95, p = 0.032). The reduction in AF recurrence was also observed in a multivariate model after adjusting for LAESVI, AF subtype, antiarrhythmic use, BMI, LVEF, and sex (HR: 0.46, 95% CI: 0.25 to 0.87, p = 0.016).

Among patients with AF who recently underwent CA, participation in at least 90 minutes of moderate intensity exercise weekly was associated with reduced risk of recurrent AF. Larger randomized trials are required to investigate optimal exercise duration, load, and timing of exercise initiation.