title: The effect of integrated cardiac rehabilitation versus treatment as usual for atrial fibrillation patients treated with ablation: the randomised CopenHeartRFA trial protocol.
abstract: BACKGROUND
  Atrial fibrillation affects almost 2% of the population in the Western world. To preserve sinus rhythm, ablation is undertaken in symptomatic patients. Observational studies show that patients with atrial fibrillation often report a low quality of life and are less prone to be physically active due to fear of triggering fibrillation. Small trials indicate that exercise training has a positive effect on exercise capacity and mental health, and both patients with recurrent atrial fibrillation and in sinus rhythm may benefit from rehabilitation in managing life after ablation. No randomised trials have been published on cardiac rehabilitation for atrial fibrillation patients treated with ablation that includes exercise and psychoeducational components.
  
  
  OBJECTIVE
  To test the effects of an integrated cardiac rehabilitation programme versus treatment as usual for patients with atrial fibrillation treated with ablation.   METHODS AND ANALYSIS DESIGN:  The trial is a multicentre parallel arm design with 1:1 randomisation to the intervention and control group with blinded outcome assessment. 210 patients treated for atrial fibrillation with radiofrequency ablation will be included. The intervention consists of a rehabilitation programme including four psychoeducative consultations with a specially trained nurse and 12 weeks of individualised exercise training, plus the standard medical follow-up. Patients in the control group will receive the standard medical follow-up. The primary outcome measure is exercise capacity measured by the VO(2) peak. The secondary outcome measure is self-rated mental health measured by the Short Form 36 questionnaire. Postintervention, qualitative interviews will be conducted in 10% of the intervention group.
  
  
  BACKGROUND
  The protocol is approved by the regional research ethics committee (number H-1-2011-135), the Danish Data Protection Agency (reg. nr. 2007-58-0015) and follows the latest version of the Declaration of Helsinki. The results will be published in peer-reviewed journals and may possibly impact on rehabilitation guidelines.
  
  
  BACKGROUND
  Clinicaltrials.gov identifier: NCT01523145.
authors: The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen Denmark.
authors: Signe Stelling
authors: SS
authors: Risom
authors: Ann-Dorth Olsen
authors: AD
authors: Zwisler
authors: Trine Bernholdt
authors: TB
authors: Rasmussen
authors: Kirstine Lærum
authors: KL
authors: Sibilitz
authors: Jesper Hastrup
authors: JH
authors: Svendsen
authors: Christian
authors: C
authors: Gluud
authors: Jane Lindschou
authors: JL
authors: Hansen
authors: Per
authors: P
authors: Winkel
authors: Lau Caspar
authors: LC
authors: Thygesen
authors: Merja
authors: M
authors: Perhonen
authors: Jim
authors: J
authors: Hansen
authors: Sandra B
authors: SB
authors: Dunbar
authors: Selina Kikkenborg
authors: SK
authors: Berg