PMID 36315143

Research
All papers

Effect of High-Intensity Interval Training in Patients With Atrial Fibrillation: A Randomized Clinical Trial

Reed JL, Terada T, Vidal-Almela S, Tulloch HE, Mistura M, Birnie DH, Wells GA, Nair GM, Hans H, Way KL, Chirico D, O'Neill CD, Pipe AL

Question

Does 12 weeks of HIIT improve functional capacity and quality of life more than moderate-to-vigorous cardiovascular rehabilitation in patients with persistent or permanent atrial fibrillation?

Summary

In adults with persistent or permanent atrial fibrillation, a supervised twice-weekly 23-minute cycling HIIT program produced similar 12-week improvements to a 60-minute cardiovascular rehabilitation program in walking distance, quality of life, resting heart rate, and physical activity. HIIT used much less conditioning time but had more dropouts and a small number of exercise-related adverse events.

Methodology

  • Adults with persistent or permanent atrial fibrillation in a cardiac rehabilitation center
  • 86 participants.
  • Upright cycle ergometer.
  • Work intervals: 30 s at 80%-100% peak power output.
  • Recovery: 30 s active recovery; 4 min between two blocks.
  • Intensity: 80%-100% PPO after progression, with possible increases up to 150% PPO.
  • 23 min.
  • 2 sessions/week.
  • 12 weeks.
  • Single-center parallel-group randomized clinical trial
  • 6-minute walk distance, General quality of life, Atrial fibrillation burden, and Adherence and safety were tracked.

Outcomes

6MWT

Both groups improved, with no significant between-group difference.

No clear change

Quality of life

General and disease-specific quality-of-life changes did not differ significantly between groups.

No clear change

Physical activity

Moderate-to-vigorous physical activity changes were similar.

Unclear

Safety

Exercise-related adverse events were uncommon, but HIIT had more dropouts.

Unclear

Insights

  • For stable AF patients in a supervised clinical setting, 30-second cycling intervals can reduce time burden while preserving rehabilitation benefits.
  • HIIT equivalence should be paired with careful screening, monitoring, and symptom reporting.
  • Clinical HIIT protocols are not automatically transferable to unsupervised consumer workouts.

Limitations

  • Single-center trial
  • More dropouts in the HIIT group
  • No long-term follow-up beyond post-intervention testing
  • Findings apply to medically screened stable AF patients

Safety

  • 2 exercise-related adverse events occurred during 749 HIIT sessions.
  • One listed exercise-related event included knee swelling/medial collateral ligament tear.
  • HIIT had significantly more dropouts than CR.
  • Participants were medically screened and trained under supervision.