Moderate physical exercise: a simplified approach for ventricular rate control in older patients with atrial fibrillation

Clin Res Cardiol. 2008 Nov;97(11):820-6. doi: 10.1007/s00392-008-0692-3. Epub 2008 Jul 21.


Aims: This prospective pilot-study was performed to assess whether regular moderate physical activity elevates the parasympathetic tone to the atrio-ventricular node and decreases VR during permanent AF.

Background: Adequate ventricular rate (VR) control in patients with permanent atrial fibrillation (AF) is not easy to accomplish.

Methods: 10 patients (mean age 59 +/- 10 years) with permanent AF (duration: 10 +/- 8 years) underwent moderate physical exercise adjusted to their individual physical capability (45 min walking/jogging twice a week). To analyze VR control physical exercise tests and Holter-ECG recordings were performed before and after 4 months. In addition, stepwise lactate tests and psycho-pathometric examinations were obtained.

Results: After 4 months of training, there was a trend toward a decrease of mean VR in 24 h Holter-ECGs by 12% from 76 +/- 20 to 67 +/- 12 bpm (P = 0.05) while there was no significant decrease of the minimal VR (38 +/- 8 vs. 36.3 +/- 4.5 bpm, P = 0.54). At a lactate threshold of 2 mmol/l there was a trend towards an increase of the running speed from 105 +/- 11 to 116 +/- 12 m/min (P = 0.05). A significant VR decrease of 8% (range 5-10%) was observed at almost all exercise levels during exercise treadmill testing. Increases of exercise capacity and decreases of VR were accompanied by subjective improvements of health perception.

Conclusion: Regular moderate physical activity decreases VR at rest and during exercise while increasing exercise capacity. Physical training should be taken into account for ventricular rate control during AF.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / therapy*
  • Electrocardiography
  • Exercise Test
  • Exercise*
  • Female
  • Heart Rate*
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Physical Fitness
  • Pilot Projects
  • Prospective Studies
  • Treatment Outcome
  • Walking