Abstract 15833: Impact of Sex on Outcomes Following Aerobic Exercise Training in Patients With Symptomatic Atrial Fibrillation

Abstract

Introduction: Aerobic exercise prescription may promote maintenance of sinus rhythm in patients with atrial fibrillation (AF). Very little data exists on whether this may be modified by patient sex. Hypothesis: Male and female patients with AF would benefit from exercise prescription. Methods: This study was a prospective, randomized, controlled trial of patients with symptomatic paroxysmal or persistent AF, referred for consideration of AF ablation. Randomization was 1:1 to either aerobic exercise intervention or usual medical care for a period of 6 months with a further 6 months follow-up. The exercise intervention was delivered in a hybrid format of weekly supervised exercise sessions coupled with prescribed home exercise, up to a total of 210 minutes per week. The intervention was led by a clinical exercise physiologist. Management of arrhythmia was at the discretion of a cardiologist blinded to patient randomization. The primary endpoint reported here is recurrent AF without rhythm control strategies. Results: Of the 120 patients enrolled in the study (Aged 65±10, BMI 30±6, 38% Persistent AF), 51 were female (42.5%). Female patients were less likely to have persistent AF at baseline (19.6%) compared to males (47.8%), had comparable BMI (30.8 v 30.2 kg/m 2 ), were older (68±7 v 63±11 years) and had lower baseline peak oxygen uptake (16±4 v 23±5mL/kg/min, p<0.001). After 12-mnths of follow-up, both male (HR 0.52, 95% CI: 0.29-0.91, p=0.02) and female patients (HR 0.47, 95% CI: 0.23-0.95) in the exercise group had reduced recurrence of AF without anti-arrhythmic medication or AF ablation. Conclusions: Despite baseline differences in risk factor profile, aerobic exercise training is equally effective in males and females for the reduction of recurrent arrhythmia amongst patients with symptomatic atrial fibrillation. Exercise-based intervention should be recommended to patients of both sex, to promote the maintenance of sinus rhythm.