BOSTON — Regular, moderate exercise can help control ventricular rate in patients with permanent atrial fibrillation, according to study results presented as a poster at the annual meeting of the Heart Rhythm Society.
“Patients with atrial fibrillation [AF] find it difficult to exercise, so this is a new idea,” investigator Dr. Jurgita Plisiene said in an interview.
Ventricular rate increases during exercise, making it difficult for the patients to improve their exercise capacity. But Dr. Plisiene found that 4 months of twice-weekly exercise, involving walking or jogging for 60 minutes, increased exercise capacity in 10 patients with permanent AF, while also regulating the ventricular rate. “Exercise elevates the parasympathetic tone to the [atrioventricular] node and so decreases the ventricular rate,” she said.
The patients had a mean age of 59 years and a mean 10 years' duration of permanent AF. They undertook individualized, physician-directed exercise programs tailored to their physical capacity. Physical exercise tests and Holter ECG recordings were performed at baseline and after 4 months.
Results showed that the exercise program decreased the patients' mean ventricular rate by 12%. The mean rate at rest decreased from 87 to 78 beats per minute, and there was a significant ventricular rate decrease at almost every exercise level.
In addition, overall exercise capacity, as estimated by repeated lactate measurements and by questionnaires, also significantly improved. “Physical training should be taken into account in those patients in whom drug therapy does not allow the heart to reach adequate ventricular rate control during AF,” said Dr. Plisiene, a cardiologist at University Hospital in Aachen, Germany.