title: Cardiovascular exercise and burden of arrhythmia in patients with atrial fibrillation - A randomized controlled trial.
abstract: BACKGROUND
  Physical activity at moderate-high intensity is recommended to prevent lifestyle diseases. Patients with atrial fibrillation are at risk of a sedentary lifestyle due to fear of exercise-induced episodes of atrial fibrillation. The burden of arrhythmia can be reduced by physical exercise. The effect of exercise intensity on burden of atrial fibrillation needs to be studied further.
  
  
  RESULTS
  In a 12-week randomized controlled trial, 76 patients with paroxysmal/persistent atrial fibrillation were allocated to perform exercise at either low intensity or high intensity (50% and 80% of maximal perceived exertion, respectively). Primary outcome was burden of AF measured by daily electrocardiography-reporting during 12 weeks. Secondarily, change in maximal oxygen uptake (peak VO2) and 1-year hospitalization was compared between low and high intensity exercise. Sixty-three patients completed the follow-up. In the intention-to-treat analysis, we found no statistical difference in burden of atrial fibrillation between low and high intensity exercise (incidence rate ratio 0.742, 95% CI 0.29-1.91, P = 0.538). No serious adverse events were reported and there was no difference in hospitalization between the two exercise groups. Both exercise groups improved significantly in peak VO2 (low intensity: 3.62 mL O2/kg/min, SD 3.77; high intensity: 2.87 mL O2/kg/min, SD 4.98), with no statistical difference between-groups (mean difference: 0.76 mL O2/kg/min, 95% CI -3.22-1.7).
  
  
  CONCLUSIONS
  High intensity physical exercise was not superior to low intensity physical exercise in reducing burden of atrial fibrillation. HI exercise was well tolerated; no evidence of an increased risk was found for HI compared to LI exercise. Larger studies are required to further prove our findings.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01817998.
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.
authors.forename: Ane Katrine
authors.identifier: http://orcid.org/0000-0001-9523-3760
authors.initials: AK
authors.lastname: Skielboe
authors.affiliation: Clinical Research Centre, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.|Physical Medicine and Rehabilitation Research - Copenhagen (PMR-C), Department of Physical Therapy, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.|Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.
authors.forename: Thomas Quaade
authors.initials: TQ
authors.lastname: Bandholm
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.
authors.forename: Stine
authors.initials: S
authors.lastname: Hakmann
authors.affiliation: Physical Medicine and Rehabilitation Research - Copenhagen (PMR-C), Department of Physical Therapy, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.
authors.forename: Malene
authors.initials: M
authors.lastname: Mourier
authors.affiliation: Clinical Research Centre, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kallemose
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Dixen
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D004562:Electrocardiography; D015444:Exercise; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D010100:Oxygen