Effect of High-Intensity Interval Training in Patients With Atrial Fibrillation: A Randomized Clinical Trial.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 36315143 · doi:10.1001/jamanetworkopen.2022.39380
What was done
This randomized clinical trial at a single tertiary care center in Ottawa, Canada, compared 12 weeks of twice-weekly high-intensity interval training (HIIT: 23 minutes total, comprising two 8-minute blocks of 30-second work periods at 80%–100% peak power output interspersed with 30-second recovery) against standard continuous cardiovascular rehabilitation (CR: 60 minutes continuous aerobic conditioning at 67%–95% peak heart rate) in 86 participating patients with persistent or permanent atrial fibrillation (AF). Primary outcomes were changes from baseline to 12 weeks in functional capacity (6-minute walk test distance) and general quality of life (SF-36). Secondary outcomes were disease-specific quality of life, resting heart rate, physical activity levels, and time in AF, evaluated by intention-to-treat analysis.
What was found
No statistically significant differences between the HIIT and CR groups were observed at 12 weeks: - 6-minute walk test distance change: mean (SD) 21.3 (34.1) m for HIIT vs 13.2 (55.2) m for CR (P = .42). - General quality of life (Physical Component Summary): mean (SD) 0.5 (6.1) points for HIIT vs 1.1 (4.9) points for CR (P = .87). - Disease-specific AF symptoms: mean (SD) -1.7 (4.3) points for HIIT vs -1.5 (4.0) points for CR (P = .59). - Resting heart rate change: mean (SD) -3.6 (10.6) bpm for HIIT vs -2.9 (12.4) bpm for CR (P = .63). - Moderate-to-vigorous physical activity change: mean (SD) 37.3 (93.4) min/wk for HIIT vs 14.4 (125.7) min/wk for CR (P = .35). - Session attendance: mean (SD) 18.3 (6.1) sessions (75.1%) for HIIT vs 20.0 (4.5) sessions (83.4%) for CR (P = .36). Specific numeric values for time in AF were not reported in the abstract.
Why it matters
Time-efficient HIIT (23 minutes) achieved comparable clinical and functional benefits to standard-duration (60 minutes) cardiac rehabilitation in patients with persistent or permanent AF. This indicates that shorter interval-based training is a viable alternative to traditional continuous exercise in this population.
Limits
The trial was conducted at a single center with a modest sample size (86 participants analyzed). The cohort was predominantly male (66.3%), limiting generalizability to female patients. Only 12-week outcomes were evaluated, and numeric data for time in AF were omitted from the abstract.
Cited by
- supports High-intensity interval training (HIIT) is an effective intervention for improving health outcomes in patients with heart failure and atrial fibrillation.