Afib, Heart Failure, and Exercise

The prognosis of

comorbid Afib and heart failure

is worse than either one alone. Current study looked at the impact of systematic exercise in patients with AF and HFrEF in stable outpatients from

HF-ACTION study

cohort. (MI, myocardial infarction; OSA, obstructive sleep apnea; HTN, hypertension)

HF-ACTION:

Patients with HFrEF (EF less than 35%), NYHA Class II-IV symptoms; safety/efficacy of exercise training w CHF meds vs CHF meds alone. Goal: initially 90 min/wk for 3 mo, eventually 120 min/wk. (RCT, randomized controlled trial; NYHA, New York Heart Association, CHF, congestive heart failure)

HF-ACTION Results

(DM, diabetes mellitus; KCCQ,

Kansas City cardiomyopathy questionnaire

)

HF-ACTION Conclusions:

In HF patients with AF, exercise training is not associated with fewer AF events (hospitalization due to AF or SAE for symptomatic AF).

HF-ACTION Interpretation:

Exercise in AF with HFrEF is safe and results in a positive functional response similar to SR patients.

HF-ACTION Next Steps:

Additional RCTs are needed to determine if response to exercise is heterogeneous amongst HFrEF patients and whether clinical predictors can be used to determine which patients are likely to benefit the most.