Is exercise safe in HF patients who have AF? Results of the HF-ACTION study are summarized in this short slide show.
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
cohort. (MI, myocardial infarction; OSA, obstructive sleep apnea; HTN, hypertension)
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)
In HF patients with AF, exercise training is not associated with fewer AF events (hospitalization due to AF or SAE for symptomatic AF).
Exercise in AF with HFrEF is safe and results in a positive functional response similar to SR patients.
The HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training) study evaluated the safety and efficacy of exercise training in heart failure patients with atrial fibrillation. Clinical characteristics and outcomes (mortality/hospitalizations) were assessed by baseline AF status: past history of AF or AF on baseline electrocardiogram vs no AF).Click through this short slide show for a topline review of study methods, results, and interpretation. Additional study notes below.Additional Notes:Â -- n=308 (13%) of patient excluded due to “other” rhythmÂ -- Overall, mean age was ~59y, 30% female, 60% white, 34% black.Â -- All patients >90% use of beta-blockers and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers at baseline.Â -- Adjustment for dosage of beta-blocker, KCCQ symptom stability, LVEF, country, sex, ventricular conduction, Weber class, blood urea nitrogen, and mitral regurgitation.Link to study abstract: Luo N, Merrill P, Parikh KS, et al. Exercise training in patients with chronic heart failure and atrial fibrillation. J Am Coll Cardiol. 2017 Apr 4;69:1683-1691. doi: 10.1016/j.jacc.2017.01.032.