Effects of Exercise Training in Patients With Permanent Atrial Fibrillation

Study Overview
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Brief Summary
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Atrial fibrillation (AF) is a common arrhythmia. The proposed patholophysiological mechanisms of AF include abnormal electrical conduction in atrium and sympathovagal imbalance with increased vagal tone. Patients with AF have poor exercise capacity that may contribute to decreased atrial effective refractory period, and decreased cardiac output and heart rate reserve, and may result in poor quality of life. Poor endothelial function had been noted in patients with AF, associated with increased risks of cerebrovascular and cardiovascular disease. Exercise training has been noted to improve exercise capacity and quality of life in patients with AF only in some studies. Endothelial function can be improved by exercise training in patients with cardiovascular disease, but no report in patients with AF. Evidence of exercise training is still needed in patients with AF. The purpose of this study is to investigate the effect of exercise training on endothelial function heart rate variability exercise capacity quality of life.

Detailed Description
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A randomized controlled study was implemented to examine :(1) the effect of interval aerobic exercise training combined with resistance training on endothelial function, heart rate variability (HRV), exercise capacity, and quality of life (QoL); (2) the influential factors related to exercise capacity, and the relationship between exercise capacity and quality of life in patients with permanent atrial fibrillation (AF).

Official Title
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Effects of Exercise Training on Endothelial Function, Heart Rate Variability, Exercise Capacity, and Quality of Life in Patients With Permanent Atrial Fibrillation

Conditions
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Atrial Fibrillation

Intervention / Treatment
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* Other: Exercise training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Permanent atrial fibrillation≥ 1 year aged 40-76 years Recurrence AF after ablation Under antiarrhythmia medication control Exclusion Criteria: CAD or myocardial infrarction history NYHA≥ III-IV, or LVEF≤45% Mitral or aortic valve regurgitation ≥ Gr. II Mitral valve or aortic valve stenosis Pacemaker Cardioversion by ablation Pulmonary artery hypertension Any surgery in previous 3 months Any neurological disorders Cancer Severe musculoskeletal disorder Hyperthyroidism Premenopausal women

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 76 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Exercise training<br>Exercise group will undergo progressively aerobic exercise training with 40-85% maximal oxygen consumption for 40 minutes, 3 sessions per week for 12 weeks. | Other: Exercise training<br>* Exercise group will undergo progressively aerobic exercise training with 40-85% maximal oxygen consumption for 40 minutes, 3 sessions per week for 12 weeks.<br>* Other names: Aerobic exercise Training;|
| No Intervention: control group<br>Control group conducted the usual care | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of exercise capacity (after intervention) | To measure maximal oxygen consumption, maximal oxygen pulse, maximal heart rate and blood pressure, cumulated and peak workload by cycle ergometer with Vmax 229 system | At baseline and 12 weeks after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of heart rate variability (after intervention) | To record ECG by lead V1 with KENZ 170 on supine position for 1 hour | At baseline and 12 weeks after intervention | 
| Change values of head up tilt test (after intervention) | Subjects were tilted up 60 degree on tilting table for 15 minutes to record the change of blood pressure and heart rate, and heart rate variability. | At baseline and 12 weeks after intervention | 
| Change of endothelial function (after intervention) | To measure dependent-endothelial moulation by flow-mediated dilatation with Sonosite 180 portable ultrasound. | At baseline and 12 weeks after intervention | 
| Change of quality of life (after intervention) | To measure quality of life by Short-form 36 and symptom checklist | At baseline and 12 weeks after intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Atrial Fibrillation, Exercise Training, Endothelial Function, Autonomic Nerve Modulation, Exercise Capacity, Quality of Life