Moderate physical exercise: a simplified approach for ventricular rate control in older patients with atrial fibrillation.
OBJECTIVE
This prospective pilot-study was performed to assess whether regular moderate physical activity elevates the parasympathetic tone to the atrio-ventricular node and decreases VR during permanent AF.


BACKGROUND
Adequate ventricular rate (VR) control in patients with permanent atrial fibrillation (AF) is not easy to accomplish.


METHODS
10 patients (mean age 59 +/- 10 years) with permanent AF (duration: 10 +/- 8 years) underwent moderate physical exercise adjusted to their individual physical capability (45 min walking/jogging twice a week). To analyze VR control physical exercise tests and Holter-ECG recordings were performed before and after 4 months. In addition, stepwise lactate tests and psycho-pathometric examinations were obtained.


RESULTS
After 4 months of training, there was a trend toward a decrease of mean VR in 24 h Holter-ECGs by 12% from 76 +/- 20 to 67 +/- 12 bpm (P = 0.05) while there was no significant decrease of the minimal VR (38 +/- 8 vs. 36.3 +/- 4.5 bpm, P = 0.54). At a lactate threshold of 2 mmol/l there was a trend towards an increase of the running speed from 105 +/- 11 to 116 +/- 12 m/min (P = 0.05). A significant VR decrease of 8% (range 5-10%) was observed at almost all exercise levels during exercise treadmill testing. Increases of exercise capacity and decreases of VR were accompanied by subjective improvements of health perception.


CONCLUSIONS
Regular moderate physical activity decreases VR at rest and during exercise while increasing exercise capacity. Physical training should be taken into account for ventricular rate control during AF.
Plisiene
J
J
Department of Cardiology, Pneumology, Vascular Medicine, RWTH University Aachen, Pauwelstrasse 30, 52072, Aachen, Germany.
Blumberg
A
A
Haager
G
G
Knackstedt
C
C
Latsch
J
J
Norra
C
C
Arndt
M
M
Tuerk
S
S
Heussen
N
N
Kelm
M
M
Predel
H G
HG
Schauerte
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000628:therapy*; D004562:Electrocardiography; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010809:Physical Fitness; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D016138:Walking