The type of exercise most beneficial for quality of life in people with atrial fibrillation: a network meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and network meta-analysis of randomized controlled trials
PubMed 39850377 · doi:10.3389/fcvm.2024.1509304
What was done
Authors conducted a systematic review and random-effects network meta-analysis of randomized controlled trials (RCTs) evaluating the comparative effectiveness of different exercise intervention modalities on health-related quality of life (HRQoL) in patients with atrial fibrillation (AF). Databases searched included PubMed, Web of Science, Embase, Cochrane Library, Scopus, CNKI, WanFang Data, and VIP.
What was found
Twelve RCTs were analyzed. For total HRQoL in AF patients, significant improvements were seen with aerobic exercise (standardised mean difference [SMD] 0.60, 95% CI: 0.02 to 1.13) and cardiac rehabilitation (CR; SMD 0.59, 95% CI: 0.20 to 0.99). For the physical component of HRQoL, CR ranked highest with a Surface Under the Cumulative RAnking curve (SUCRA) value of 77%. For the mental component of HRQoL, high-intensity interval training (HIIT) ranked highest with a SUCRA value of 90.7%.
Why it matters
This review helps refine exercise prescription in AF by demonstrating that different modalities yield distinct benefits, suggesting CR is best suited for physical functional recovery while HIIT confers the largest mental health gains.
Limits
The total number of randomized participants is not stated in the abstract. Risk of bias is notable among the included trials, with five showing some concerns and one displaying a high risk of bias. The lower confidence bound for aerobic exercise was close to zero (0.02). Adverse events, long-term adherence, and AF symptom burden were not reported.
Cited by
- supports High-intensity interval training (HIIT) is an effective intervention for improving health outcomes in patients with heart failure and atrial fibrillation.