Table 1

Included studies

StudyInclusion criteriaIntervention: controlExercise/controlOutcomes
Hegbom 25 Patients with chronic AF,<75 years. Exercise
8 weeks, three sessions/week. Supervised, 1.25 hours, aerobic exercise: 5 min warm-up, 3×15 min periods of aerobics @ 70%–90% HRmax interrupted by strengthening exercise (back, thighs and stomach), followed by a 5 min cool-down and 15 min of stretching. Sessions completed @ one of two rehabilitation Centres.
Control
Usual care.
15/15 randomised
13/15 analysed
Heart rate variability
Maximal heart rate
Resting heart rate
Cumulated workload (W)
Exercise time max. (min)
QoL (SF-36)
Luo 2 Heart failure patients with LVEF <35%. Sub-analysis of those with AF from HF ACTION trial. Exercise
12 weeks, three sessions/week. Supervised aerobic exercise (walking, treadmill, or cycle ergometer), followed by transition to a home-based exercise programme for an additional 2 years.
Control
Usual care.
193/189 randomised and analysed6MWD
Peak VO2
QoL (KCCQ)
All-cause mortality/ hospitalisation
Cardiovascular mortality/HF hospitalisation
Malmo 26 Patients with non-permanent AF (paroxysmal or persistent) Exercise
12 weeks, three sessions/week. Aerobic (walking/running), 10 min warm-up @ 60%–70% HRpeak, then 4×4 min intervals @ 85%–95% of HRpeak with 3 min of active recovery @ 60%–70% HRpeak between intervals.
Control
Usual care.
26/25 randomised and analysedTime in AF
AF symptoms and severity
Blood pressure
Resting heart rate
Peak heart rate
Cardiac volumes (ejection fraction)
QoL (SF-36)
Peak VO2
lipid status (TC, HDL, LDL, TG) hsCRP
BMI, weight
activity
Osbak 27 Adults with permanent AF. Exercise
12 weeks, three sessions/week, @ 70% maximal exercise capacity (Borg scale scores 14–16). Total exercise duration was 60 min 3, minimum 30 min @ 70% maximal exercise capacity.
Control
Usual care.
25/24 randomised
24/23 analysed
CO (maximal and resting)
Maximal heart rate
Resting heart rate
Blood pressure
Heart rate reserve
6MWD
Maximal power (W)
QoL (MLHF-Q and SF-36)
ANP, NT-pro-BNP
Adverse events
Pippa 28 Patients diagnosed with AF at least 3 months prior, and taking anticoagulant treatment for at least 2 months. Exercise
16 weeks, two sessions/week. 90 min sessions of qi gong training. Qi gong refers to a set of static exercises.
Control
Usual Care.
22/21 randomised and analysed6MWD
BMI
Lipids (TC, HDL)
Homocysteine
Ejection fraction
Adverse events
Risom 29 Consecutive patients planned for treatment with radiofrequency catheter ablation,≥18 years. Paroxysmal or persistent AF. Exercise
12 weeks, three sessions/week, graduated cardiovascular training based on Borg 15-point scale and strength exercises.
Control
Usual care.
105/105 randomised*Peak VO2
Maximal power (W)
STS
Max. blood pressure
QoL (SF-36, HADS)
EHRA score
Mortality, adverse events
Skielboe 10 Patients with paroxysmal/ persistent AF. Exercise
12 weeks, two sessions/week, 60 min/session, high Intensity – (80% of maximal RPE).
Comparator
12 weeks, two sessions/week, 60 min/session, low Intensity (50% of maximal RPE).
38/38 randomised†
26/29 analysed†
Burden of AF (time spent in AF)
Peak VO2
Hospital admissions
Adverse events
Wahlstrom 31 Patients with paroxysmal AF, necessitating pharmacological treatment. Exercise
12 weeks, one session a week, 60 min group session of yoga (Mediyoga) and encouraged to practice at home.
Control
Usual care.
40/40 randomised
33/36 analysed
QoL (SF-36, EuorQoL-5D)
Resting heart rate
Blood pressure
Zeren 30 Patients with permanent AF, LVEF >40%. Exercise
12 weeks, 2×15 min sessions, 7 days/week. Inspiratory muscle training a@ 30% MIP.
Control
Usual care.
19/19 randomised
17/16 analysed
Pulmonary function
Respiratory muscle strength
Adverse events
  • *Different numbers for analysis at different time points for different outcomes.

  • †Performed ITT analysis and per protocol analysis.

  • ACR, Albumin: Creatinine ratio; AF, Atrial Fibrillation; ANP, Atrial Natriuretic Peptide; BMI, Body mass index; ERHA, European Heart Rhythm Score; HADS, Hospital anxiety and depression score; HD, High density lipoprotein; HF, Heart failure; KCCQ, Kansas City Cardiomyopathy Questionnaire; LDL, Low density lipoprotein; MLHF-Q, Minnesota living with heart failure questionnaire; 6MWD, 6 minute walk distance; NT-Pro-BNP, N-terminal Pro-Brain Natriuretic Peptide; QoL, Quality of life; RPE, Rate of Perceived Exertion; SF-36, Short form-36; STS, Sit-to stand test; TC, Total cholesterol; TG, Triglycerides; eGFR, estimated Glomerular Filtration Rate; hsCRP, high-sensitive C-reactive protein.