Efficacy of Exercise Rehabilitation in Patients with Atrial Fibrillation after Radiofrequency Ablation: A Meta-Analysis of Randomized Controlled Trials
Yue Zhang, Pengna Ren, Ailing Tang, Li Dong, Xiaoyi Hu, Hong Wang, Fanglei Xu
Abstract
Background and Aims. Radiofrequency ablation is a commonly used treatment for paroxysmal atrial fibrillation (AF), but postoperative rehabilitation exercises are needed to reverse left ventricular structural and functional abnormalities. This meta-analysis aimed to evaluate the intervention effect of exercise training in patients with AF after radiofrequency ablation. Methods. A systematic literature search was conducted to identify articles in PubMed, MEDLINE, EMBASE, and the Cochrane Library from January 1, 2010 to December 1, 2021. The mean difference with 95% CI was pooled for continuous variables. We used Review Manager 5.3 for the standard meta-analysis. This study followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results. Ten randomized controlled trials (RCTs) were included, with a total of 892 patients with AF. The quality of one study was grade A, and the rest were grade B. The results of the meta-analysis showed that the improvement of 6 min walking distance (MD = 34.42, 95% CI: 3.20 to 65.63, <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mi>P</a:mi> <a:mo>=</a:mo> <a:mn>0.03</a:mn> </a:math> ), peak oxygen uptake (MD = 1.96, 95% CI: 1.14 to 2.78, <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mi>P</c:mi> <c:mo><</c:mo> <c:mn>0.001</c:mn> </c:math> ), left ventricular ejection fraction (LVEF) (MD = 0.09, 95% CI:0.01–0.17, <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mi>P</e:mi> <e:mo>=</e:mo> <e:mn>0.02</e:mn> </e:math> ), resting heart rate (MD = −4.50, 95% CI: −8.85 to −0.14, <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mi>P</g:mi> <g:mo>=</g:mo> <g:mn>0.04</g:mn> </g:math> ), and physical component summary (PCS) (MD = 3.00, 95% CI: 0.46 to 5.54, <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"> <i:mi>P</i:mi> <i:mo>=</i:mo> <i:mn>0.02</i:mn> </i:math> ) in the experimental group was significantly better than that of the control group, and the difference was statistically significant. Conclusion. Exercise training can improve the level of exercise endurance and cardiac function in patients. However, the results were limited by the quantity and quality of the studies. Large samples and high-quality studies are still needed to verify its long-term efficacy.