The Impact of Cardiac Rehabilitation on Mental and Physical Health in Patients With Atrial Fibrillation: A Matched Case-Control Study

Abstract

BackgroundPatients with atrial fibrillation (AF) experience symptom burden, exercise intolerance, weight gain, poor mental health, and diminished quality of life (QoL). Cardiac rehabilitation (CR) is recommended for patients with heart disease, and its benefits are well established, yet clinical guidelines for patients with AF do not include the referral to CR. MethodsIn this matched retrospective, case-control study, we examined the impact of CR on changes in QoL, mental health, and cardiometabolic health indicators in patients with or without persistent or permanent AF. Patients attended CR that addressed risk factor management and provided support services and exercise training twice weekly for 3 months. Height, body mass, waist circumference, blood pressure, and heart rate were measured, and the Short Form-36 and Hospital Anxiety and Depression Scale were administered at baseline and 3 months follow-up. ResultsA total of 94 patients (AF, n = 47; no AF, n = 47) (aged 70 ± 8 years) participated. Significant improvements in 2 of the 8 subscales and the Physical Component Summary of the Short Form-36 were observed across groups after CR (P < 0.05). Significant interactions revealed that the effect of CR was greater for energy, emotional well-being, social functioning, pain, and the Physical Component Summary in patients without AF (P < 0.05 for each). No significant improvements in anxiety (AF: −1.3 ± 3.4; no AF: −1.3 ± 4.3), depression (AF: −1.1 ± 2.9; no AF: −0.4 ± 2.7), body mass index (AF: −0.5 ± 1.2; no AF: −0.8 ± 1.5, kg/m2), waist circumference (AF: −1.7 ± 4.6; no AF: 0.4 ± 8.1, cm), or blood pressure (AF: −2.3 ± 17.1/−3.9 ± /9.3; no AF: 1.8 ± 16.4/−0.8 ± /9.3 mm Hg) were observed across groups after CR. ConclusionsCR improved QoL to a greater extent in patients with heart disease without than with persistent or permanent AF.