Moderate physical exercise: a simplified approach for ventricular rate control in older patients with atrial fibrillation

• Published in: Clinical research in cardiology Vol. 97; no. 11; pp. 820 - 826
• Main Authors: Plisiene, J. MD, Blumberg, A. MD, Haager, G. Msc, Knackstedt, C. MD, Latsch, J. MD, Norra, C. MD, Arndt, M. MD, Tuerk, S. Msc, Heussen, N. Msc, Kelm, M. MD, Predel, H. G. MD, Schauerte, P. MD
• Format: Journal Article
• Language: English
• Published: Dordrecht Dordrecht : D. Steinkopff-Verlag 01.11.2008; D. Steinkopff-Verlag; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; atrial fibrillation; Atrial Fibrillation - physiopathology; Atrial Fibrillation - therapy; Cardiac arrhythmia; Cardiology; Electrocardiography; Exercise; Exercise Test; Female; Heart Rate; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Original Paper; Patient Satisfaction; Physical Fitness; Pilot Projects; Prospective Studies; Treatment Outcome; ventricular rate control; Walking; exercise; atrial fibrillation; ventricular rate control
• ISSN: 1861-0684; 1861-0692
• DOI: 10.1007/s00392-008-0692-3

Aims 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. Conclusion 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.