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Exercise in atrial fibrillation: can patients do it?

Answer

Patients with atrial fibrillation (AF) can exercise, and it is often recommended as part of their management plan. However, the type and intensity of exercise should be tailored to the individual's condition and monitored by healthcare professionals.

Exercise recommendations for AF patients

Exercise and AF outcomes

Considerations for high-intensity exercise

  • High-intensity, long-duration endurance activity: The CCS/CHRS 2020 guidelines suggest offering a period of decreased exercise intensity (detraining) as a possible management strategy for patients engaged in high-intensity, long-duration endurance activity, taking into account their values and preferences
  • Catheter ablation for athletes: For athletes developing AF, the ACC/ACCP/AHA/HRS 2024 guidelines suggest considering catheter ablation with pulmonary vein isolation for rhythm control due to its effectiveness and low risk of detrimental effects on exercise capacity

In conclusion, exercise is generally beneficial for patients with AF, but the type and intensity should be individualized. High-intensity endurance exercise may increase the risk of AF, and in such cases, a period of decreased exercise intensity or catheter ablation may be considered. Regular follow-up and monitoring are essential to ensure the safety and effectiveness of the exercise program.

References

1

Atrial fibrillation

Nonpharmacologic interventions

Guidelines

Physical activity

Pathway
EACTS/.../ESC 2024