Cardiopulmonary fitness and quality of life improvements in atrial fibrillation patients following exercise-based cardiac rehabilitation: meta-analysis of randomized control trials

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics Pub Date : 2026-01-01 Epub Date: 2026-03-20 DOI:10.1016/j.clinsp.2026.100907

Zhen Zhang , Jialing He , Yinlan Hu , Shuyao Wang , GuoShu Yang , Duan Luo , Xu Bao , Guijun He , Xianchen Yang , Hanxiong Liu

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引用次数: 0

Abstract

Background

In this meta-analysis, the authors aimed to provide a comprehensive overview of the benefits of exercise and its potential implications in the management of atrial fibrillation.

Method

The authors conducted searches in PubMed, MEDLINE, EMBASE, and Cochrane databases using the terms “atrial fibrillation”, “exercise”, “cardiac rehabilitation”, or “physical activity”. The endpoints included the 6-Minute Walk Test (6MWT), maximal Oxygen uptake (VO₂max) measured by Cardiopulmonary Exercise Testing (CPET), maximal power measured by CPET, resting Heart Rate (HR), Left Ventricular Ejection Fraction (LVEF), data from the 36-Item Short Form Survey Instrument (SF-36), and AF recurrence post-ablation.

Results

The present analysis included 11 randomized control trials published in the past 15-years, involving a total of 1251 patients. The pooled analysis showed significant increases in VO₂max, 6MWT, and maximal power in AF patients post-exercise (-3.05, 95 % CI: [-4.79, -1.3], I² = 84 %, p < 0.0001; -42.07, 95 % CI: [-56.22, -27.93], I² = 0 %, p < 0.00001; -16.39, 95 % CI: [-20.76, -12.01], I² = 72 %, p < 0.00001, respectively). Sensitivity analysis results remained consistent but significantly reduced heterogeneity. The authors found that the recurrence rate was significantly lower in patients who exercised (RR = 0.76, 95 % CI: [0.62, 0.95], I² = 0 %, p = 0.01). Quality of life was assessed using the SF-36 scale, which includes eight domains. The pooled results are as follows: physical function (WMD = -6.46, 95 % CI: [-10.48, -2.44], I² = 52 %, p = 0.002), role physical (WMD = -13.02, 95 % CI: [-16.68, -9.36], I² = 32 %, p < 0.00001), general health (WMD = -7.80, 95 % CI: [-12.35, -3.25], I² = 62 %, p = 0.0008), bodily pain (WMD = -3.54, 95 % CI: [-6.82, -0.26], I² = 0 %, p = 0.03), vitality (WMD = -8.34, 95 % CI: [-14.31, -2.36], I² = 74 %, p = 0.006), social function (WMD = -6.44, 95 % CI: [-12.17, -0.72], I² = 71 %, p = 0.03), role emotional (WMD = -12.18, 95 % CI: [-16.46, -7.90], I² = 0 %, p < 0.00001), and mental health(WMD = -6.79, 95 % CI: [-11.69, -1.88], I² = 72 %, p = 0.007). Sensitivity analysis resulted in consistent outcomes with heterogeneity reduced to 0 % for all domains.

Conclusion

The present study found that exercise rehabilitation benefits patients with atrial fibrillation. Exercise can improve quality of life and possibly reduce recurrence. While it enhances cardiorespiratory fitness (VO₂max, 6MWT, maximal power), it does not significantly improve ejection fraction or heart rate.

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房颤患者在基于运动的心脏康复后的心肺健康和生活质量改善：随机对照试验的荟萃分析

背景：在这项荟萃分析中，作者旨在全面概述运动的益处及其对房颤管理的潜在影响。方法：作者在PubMed、MEDLINE、EMBASE和Cochrane数据库中使用“心房颤动”、“运动”、“心脏康复”或“身体活动”等术语进行检索。终点包括6分钟步行试验（6MWT）、心肺运动试验（CPET）测得的最大摄氧量（VO2max）、CPET测得的最大功率、静息心率（HR）、左心室射血分数（LVEF）、36项短表调查仪（SF-36）数据和消融后房颤复发。结果：本分析纳入了过去15年发表的11项随机对照试验，共涉及1251例患者。合并分析显示，AF患者运动后VO2max、6MWT和最大功率显著增加（-3.05,95% CI: [-4.79, -1.3], I2 = 84%, p < 0.0001; -42.07, 95% CI: [-56.22, -27.93], I2 = 0%, p < 0.00001; -16.39, 95% CI: [-20.76, -12.01], I2 = 72%, p < 0.00001）。敏感性分析结果保持一致，但异质性显著降低。笔者发现，运动组患者的复发率明显降低（RR = 0.76, 95% CI: [0.62, 0.95], I2 = 0%, p = 0.01）。生活质量采用SF-36量表进行评估，该量表包括八个领域。汇集结果如下:物理函数(大规模杀伤性武器= -6.46,95%置信区间CI: [-10.48, -2.44], I2 = 52%, p = 0.002),物理作用(大规模杀伤性武器= -13.02,95%置信区间CI: [-16.68, -9.36], I2 = 32%, p < 0.00001),一般健康(大规模杀伤性武器= -7.80,95%置信区间CI: [-12.35, -3.25], I2 = 62%, p = 0.0008),身体上的疼痛(大规模杀伤性武器= -3.54,95%置信区间CI: [-6.82, -0.26], I2 = 0%, p = 0.03),活力(大规模杀伤性武器= -8.34,95%置信区间CI: [-14.31, -2.36], I2 = 74%, p = 0.006),社会功能(大规模杀伤性武器= -6.44,95%置信区间CI:[-12.17, -0.72], I2 = 71%, p = 0.03)、角色情绪（WMD = -12.18, 95% CI: [-16.46, -7.90], I2 = 0%, p < 0.00001）和心理健康（WMD = -6.79, 95% CI: [-11.69, -1.88], I2 = 72%, p = 0.007）。敏感性分析得出一致的结果，所有领域的异质性降低到0%。结论：本研究发现运动康复对房颤患者有益。运动可以提高生活质量，并可能减少复发。虽然它可以增强心肺功能（最大摄氧量，最大负重重量，最大功率），但它不能显著改善射血分数或心率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.