Impact of a Structured Cardiac Rehabilitation Program on Cardiorespiratory Fitness in Patients With Atrial Fibrillation

Objective: To assess the effectiveness of tele-monitored cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation. Design: Single-centre, prospective, assessment-blinded, randomised controlled trial. Setting: Domiciliary rehabilitation with support from a tertiary care hospital. Subjects: One hundred patients who underwent ablation for atrial fibrillation were recruited. Interventions: Participants were randomly allocated to a 12-week standard rehabilitation treatment (control group) or a comprehensive, domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program (intervention group) in a 1:1 fashion. Main outcome measures: The primary endpoint was the improvement in VO2peak. The secondary outcomes included adherence, physical activity, beliefs related to cardiovascular disease and exercise self-efficacy. Results: Ninety-seven patients completed follow-up. The mean VO2peak increased significantly in both the intervention group ( n = 49) (baseline vs 12 weeks: 19.1 ± 4.7 vs 27.3 ± 5.6 ml/(min kg), P < 0.01) and the control group ( n = 48) (baseline vs 12 weeks: 18.7 ± 4.9 vs 22.9 ± 6.3 ml/(min kg), P < 0.01). The results of the between-group analysis of aerobic capacity were significantly in favour of the intervention group. During the 12-week program, patients in the intervention group exhibited better adherence than those in the control group. Moreover, self-reported physical activity improved more in the intervention group than in the control group, as did the beliefs related to cardiovascular disease and exercise self-efficacy (all P < 0.01). Conclusions: Our domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program could lead to a more significant improvements in physical fitness, adherence and health beliefs than standard cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation.

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P290The role and outcome of cardiac rehabilitation program in patients with atrial fibrillation

EP Europace ◽

10.1093/ehjci/eux141.018 ◽

2017 ◽

Vol 19 (suppl_3) ◽

pp. iii42-iii43

Author(s):

A. Younis ◽

A. Sabbag ◽

E. Nof ◽

A. Israel ◽

I. Goldenberg ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cardiac Rehabilitation ◽

Rehabilitation Program ◽

Cardiac Rehabilitation Program

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Evaluation of Mobile App-derived Cardiorespiratory Fitness and Referral Patterns in Patients Participating in a Cardiac Rehabilitation Program: A Pilot Initiative (Preprint)

10.2196/preprints.29209 ◽

2021 ◽

Author(s):

Elizabeth H Dineen ◽

Daniel Ng ◽

Emem Udoh ◽

Francis Allinson ◽

Samantha R. Spierling Bagsic ◽

...

Keyword(s):

Cardiac Rehabilitation ◽

Cardiorespiratory Fitness ◽

Rehabilitation Program ◽

Mobile App ◽

Smartphone App ◽

Cardiac Rehabilitation Program ◽

Provider Education ◽

Vo2 Max ◽

Referral Patterns ◽

The Mean

BACKGROUND Cardiac rehabilitation is known to improve morbidity and mortality; however, it is underutilized. OBJECTIVE This pilot initiative will: 1) determine if a smartphone app is able to detect meaningful differences in cardiorespiratory fitness after participation in traditional cardiac rehabilitation, 2) observe cardiac rehabilitation referral patterns and 3) monitor patient engagement in cardiac rehabilitation. METHODS During February 2020, n = 34 patients were enrolled in outpatient phase II cardiac rehabilitation at our institution and included in the initiative. A mobile phone app, Heart Snapshot, was used to estimate VO2 max at baseline and after 4 weeks of participation in cardiac rehab. Providers were surveyed about referral patterns. The plan-do-check-act cycle was used to assess improvement. RESULTS The mean age was 67 (SD: 13) and ischemic heart disease was the main reason for referral. Improvement in app-derived VO2 max was positively correlated with improvement in METs. The survey revealed provider lack of understanding of conditions benefitting from cardiac rehabilitation and discrepancy regarding responsibility referring to cardiac rehabilitation. CONCLUSIONS Cardiac rehabilitation is an important yet underutilized intervention. There is room for improvement in provider education and ownership for cardiac rehabilitation referrals. An app-based VO2 estimate may be a solution for remotely monitoring fitness improvement.

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Effects of a simple cardiac rehabilitation program on improvement of self-reported physical activity in atrial fibrillation – Data from the RACE 3 study

IJC Heart & Vasculature ◽

10.1016/j.ijcha.2020.100673 ◽

2020 ◽

Vol 31 ◽

pp. 100673

Author(s):

Bao Oanh Nguyen ◽

E.P.J. Petra Wijtvliet ◽

Anne H. Hobbelt ◽

Simone I.M. De Vries ◽

Marcelle D. Smit ◽

...

Keyword(s):

Physical Activity ◽

Atrial Fibrillation ◽

Cardiac Rehabilitation ◽

Rehabilitation Program ◽

Cardiac Rehabilitation Program

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Is the Clinical Delivery of Cardiac Rehabilitation in an Australian Setting Associated with Changes in Physical Capacity and Cardiovascular Risk and Are Any Changes Maintained for 12 Months?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18178950 ◽

2021 ◽

Vol 18 (17) ◽

pp. 8950

Author(s):

Kym Joanne Price ◽

Brett Ashley Gordon ◽

Stephen Richard Bird ◽

Amanda Clare Benson

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Waist Circumference ◽

Cardiac Rehabilitation ◽

Cardiovascular Risk Factors ◽

Cardiorespiratory Fitness ◽

Rehabilitation Program ◽

Physical Capacity ◽

Moderate Intensity ◽

Cardiac Rehabilitation Program

Long-term maintenance of changes in cardiovascular risk factors and physical capacity once patients leave the supervised program environment have not previously been reported. This study investigated the changes in physical capacity outcomes and cardiovascular risk factors in an Australian cardiac rehabilitation setting, and the maintenance of changes in these outcomes in the 12 months following cardiac rehabilitation attendance. Improvements in mean (95% CI) cardiorespiratory fitness (16.4% (13.2–19.6%), p < 0.001) and handgrip strength (8.0% (5.4–10.6%), p < 0.001) were observed over the course of the cardiac rehabilitation program, and these improvements were maintained in the 12 months following completion. Waist circumference (p = 0.003) and high-density lipoprotein cholesterol (p < 0.001) were the only traditional cardiovascular risk factors to improve during the cardiac rehabilitation program. Vigorous-intensity aerobic exercise was associated with significantly greater improvements in cardiorespiratory fitness, Framingham risk score, and waist circumference in comparison to moderate-intensity exercise. An increase in the intensity of the exercise prescribed during cardiac rehabilitation in Australia is recommended to induce larger improvements in physical capacity outcomes and cardiovascular risk. A standardized exercise test at the beginning of the rehabilitation program is recommended to facilitate appropriate prescription of exercise intensity.

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