Effects of different exercise types on quality of life for patients with atrial fibrillation: a systematic review and meta-analysis

Author: Ahlam AbuElkhair1,2,3, Maxime Boidin4,2,5, Benjamin J R Buckley1,4,2, Deirdre A Lane1,2,6, Nefyn H Williams2,7, Dick Thijssen4, Gregory Y H Lip1,2,6, Dong L Barraclough8
1 Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom.
2 Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.
3 Department of Physiotherapy, Faculty of Medical Technology, University of Tripoli, Libya.
4 Research Institute for Sport and Exercise Sciences, Liverpool John Moores University and Liverpool Centre for Cardiovascular Sciences, Liverpool, U.K.
5 Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom.
6 Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
7 Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, U.K.
8 Department of Musculoskeletal & Ageing Sciences, Institute of Life Course and Medical Sciences, University of Liverpool, U.K.
Conference/Journal: J Cardiovasc Med (Hagerstown)
Date published: 2023 Feb 1
Other: Volume ID: 24 , Issue ID: 2 , Pages: 87-95 , Special Notes: doi: 10.2459/JCM.0000000000001386. , Word Count: 240

To investigate the effectiveness of exercise and the most effective types of exercise for patients with atrial fibrillation (AF) to improve health-related quality of life (HRQoL) and exercise capacity, and reduce AF burden, AF recurrence and adverse events.

Methods and results:
Systematic search in PubMed, Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL Plus, and SPORTDiscus for randomized controlled trials (RCTs) and nonrandomized pre-post intervention studies investigating the effect of different types of exercise on AF patients. After exclusion, 12 studies (11 RCTs, 1 prepost) with a total of 670 participants were included. Exercise interventions consisted of aerobic exercise, aerobic interval training (AIT), Qigong, yoga, and exercise-based cardiac rehabilitation (CR). There were significant positive effects of exercise on general health {mean difference [MD] = 6.42 [95% confidence interval (CI): 2.90, 9.93]; P = 0.0003; I2 = 17%} and vitality [MD = 6.18 (95% CI: 1.94, 10.41); P = 0.004; I2 = 19%)] sub-scales of the Short Form 36-item questionnaire (SF-36). Qigong resulted in a significant improvement in the 6-min walk test [MD = 105.00m (95% CI: 19.53, 190.47)]. Exercise-based CR and AIT were associated with a significant increment in V̇O2peak, and AIT significantly reduced AF burden. Adverse events were few and one intervention-related serious adverse event was reported for exercise-based CR.

Exercise led to improvements in HRQoL, exercise capacity, and reduced AF burden. The available exercise interventions for AF patients are few and heterogeneous. Future studies are needed for all types of exercise intervention in this patient group to (co-)develop an optimized exercise training intervention for AF patients.

PMID: 36583977 DOI: 10.2459/JCM.0000000000001386