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. 2021 Jan 23;10(3):435.
doi: 10.3390/jcm10030435.

Association of Exercise-Based Cardiac Rehabilitation with Progression of Paroxysmal to Sustained Atrial Fibrillation

Benjamin J R Buckley  1 , Stephanie L Harrison  1 , Elnara Fazio-Eynullayeva  2 , Paula Underhill  3 , Deirdre A Lane  1   4 , Dick H J Thijssen  5   6 , Gregory Y H Lip  1   4
Affiliations

Association of Exercise-Based Cardiac Rehabilitation with Progression of Paroxysmal to Sustained Atrial Fibrillation

Benjamin J R Buckley et al. J Clin Med. .

Abstract

Progression of atrial fibrillation (AF) is associated with worsened prognosis for cardiovascular events and mortality. Exercise-based-cardiac rehabilitation programmes have shown preliminary promise for primary and secondary prevention of AF. Yet, such interventions are typically reserved for patients with acute coronary syndrome or undergoing revascularization. Using a retrospective cohort design, the present study investigated the association of exercise-based cardiac rehabilitation on the progression of paroxysmal to sustained AF, compared to propensity-matched controls. Patients with a diagnosis of paroxysmal AF were compared between those with and without an electronic medical record of exercise-based cardiac rehabilitation within 6-months of diagnosis. Using cox regression models, we ascertained odds of 2-year incidence for AF progression. This cohort of 9808 patients with paroxysmal AF demonstrated that exercise-based cardiac rehabilitation was associated with 26% lower odds of AF progression (odds ratio 0.74, 95% CI 0.66-0.83) compared to propensity-matched controls. This beneficial effect seemed to vary across patient subgroups. In conclusion, findings revealed that exercise-based cardiac rehabilitation was associated with significantly lower odds of progression from paroxysmal to sustained AF at 2-years follow-up compared to propensity-matched controls.

Keywords: atrial fibrillation; cardiac rehabilitation; disease progression; rehabilitation; secondary prevention.

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Conflict of interest statement

Benjamin J. R. Buckley has received funding from Pfizer. Stephanie L. Harrison has received funding from Bristol-Myers Squibb (BMS). Elnara Fazio-Eynullayeva and Paula Underhill are employees of TriNetX LLC. Deirdre A. Lane has received investigator-initiated educational grants from Bristol-Myers Squibb (BMS), has been a speaker for Boehringer Ingeheim, and BMS/Pfizer and has consulted for BMS, Boehringer Ingelheim, and Daiichi-Sankyo. Gregory Y. H. Lip: consultant for Bayer/Janssen, BMS/Pfizer, Medtronic, Boehringer Ingelheim, Novartis, Verseon and Daiichi-Sankyo and speaker for Bayer, BMS/Pfizer, Medtronic, Boehringer Ingelheim, and Daiichi–Sankyo. No fees are directly received personally.

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