Cardiorespiratory fitness predicts AF recurrence – CARDIO-FIT Study

Cardiorespiratory fitness predicts AF recurrence – CARDIO-FIT Study

Obesity is an important risk factor for atrial fibrillation (AF) and lack of physical activity is an important risk factor for the development obesity. Weight loss has been shown to reduce the burden of AF [5]. Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation Cohort: A Long-Term Follow-Up Study (LEGACY) showed that progressive weight loss had a quantitative relationship with the reduction AF burden [2].

CARDIOrespiratory FITness on Arrhythmia Recurrence in Obese Individuals With Atrial Fibrillation (CARDIO-FIT Study) [3] evaluated the benefit of cardiorespiratory fitness improvement on rhythm control in obese individuals with AF. 825 patients with atrial fibrillation and body mass index of 27 Kg per sq. m. were offered risk factor management and participation in a tailored exercise program. 308 of them were included in the final analysis after the exclusions.

Those with high cardiorespiratory fitness had the greatest arrhythmia free survival (p < 0.001). Those who gained 2 METS or more also had the greatest arrhythmia free survival compared to those who gained less than 2 METS of exercise tolerance by the program (p < 0.001).

Authors concluded that improvement in cardiorespiratory fitness adds on to the beneficial effects of weight loss.

References

1. Abed HS, Wittert GA, Leong DP, Shirazi MG, Bahrami B, Middeldorp ME, Lorimer MF, Lau DH, Antic NA, Brooks AG, Abhayaratna WP, Kalman JM, Sanders P. Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. JAMA 310:2050–2060.
2. Pathak RK, Middeldorp ME, Meredith M, Mehta AB, Mahajan R, Wong CX, Twomey D, Elliott AD, Kalman JM, Abhayaratna WP, Lau DH, Sanders P. Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation Cohort: A Long-Term Follow-Up Study (LEGACY). J Am Coll Cardiol 65:2159–2169.
3. Pathak RK, Elliott A, Middeldorp ME, Meredith M, Mehta AB, Mahajan R, Hendriks JM, Twomey D, Kalman JM, Abhayaratna WP, Lau DH, Sanders P. Impact of CARDIOrespiratory FITness on Arrhythmia Recurrence in Obese Individuals With Atrial Fibrillation: The CARDIO-FIT Study. J Am Coll Cardiol. 2015 Sep 1;66(9):985-96.