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Improvement in exercise performance after successful cardioversion in patients with persistent atrial fibrillation and symptoms of heart failure.
Kardiol Pol. 2003 Sep; 59(9):213-23.KP

Abstract

BACKGROUND

Loss of atrial systolic function as well as fast and irregular ventricular response result in the impairment of hemodynamic function in patients with atrial fibrillation (AF). AF is considered to be a less efficient cardiac rhythm than sinus rhythm (SR), and accounts for the symptoms of reduced exercise tolerance, such as fatigue, tiredness or dyspnoea. In more severe cases, the hemodynamic alterations can result in heart failure.

AIM

To assess exercise performance before and one month after cardioversion of persistent AF.

METHODS

We studied 42 patients with mild to moderate clinically stable heart failure and persistent AF (median duration 7 months) with controlled ventricular rate. They underwent submaximal exercise testing 24 hours before cardioversion and one month after cardioversion. Exercise capacity was determined during symptom-limited exercise testing, according to a modified Bruce protocol with peak VO(2) analysis.

RESULTS

Thirty-five (83%) patients were successfully cardioverted to SR. One month after cardioversion 29 patients remained in SR (SR group) while 6 had recurrence of AF, and, together with patients with unsuccessful cardioversion, formed the AF group (n=13). Baseline patient characteristics did not differ between the SR and AF groups. Left ventricular ejection fraction (52.7+/-10.2% vs 56.5+/-9.6%, NS) and exercise tolerance (peak VO(2) 19.85+/-3.5 ml/min/kg vs 22.2+/-3,4 ml/kg/min, NS; and exercise duration 9.5+/-3.4 min vs 10.6+/-2.4 min; NS) were similar in both groups before cardioversion. Successful cardioversion resulted in a mean decrease in resting heart rate of 28 beats/minute (94.7+/-10.3 vs 66.7+/-9.7 beats/min, p<0.05), measured 30 days after cardioversion, and a significant improvement in exercise tolerance in the SR group: exercise duration increased from 9.5+/-3.4 min to 13.7+/-3.2 min, p<0.05; and peak oxygen consumption increased from 19.85+/-3.5 ml/min/kg to 32.2+/-3.6 ml/min/kg, p<0.05. No improvement was observed in the AF group.

CONCLUSIONS

Restoration of sinus rhythm in patients with persistent AF is associated with a significant improvement in exercise capacity one month after cardioversion.

Authors+Show Affiliations

Department of Cardiology, Regional District Hospital, Kielce, Poland.No affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

14618198

Citation

Wozakowska-Kapłon, Beata, and Grzegorz Opolski. "Improvement in Exercise Performance After Successful Cardioversion in Patients With Persistent Atrial Fibrillation and Symptoms of Heart Failure." Kardiologia Polska, vol. 59, no. 9, 2003, pp. 213-23.
Wozakowska-Kapłon B, Opolski G. Improvement in exercise performance after successful cardioversion in patients with persistent atrial fibrillation and symptoms of heart failure. Kardiol Pol. 2003;59(9):213-23.
Wozakowska-Kapłon, B., & Opolski, G. (2003). Improvement in exercise performance after successful cardioversion in patients with persistent atrial fibrillation and symptoms of heart failure. Kardiologia Polska, 59(9), 213-23.
Wozakowska-Kapłon B, Opolski G. Improvement in Exercise Performance After Successful Cardioversion in Patients With Persistent Atrial Fibrillation and Symptoms of Heart Failure. Kardiol Pol. 2003;59(9):213-23. PubMed PMID: 14618198.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improvement in exercise performance after successful cardioversion in patients with persistent atrial fibrillation and symptoms of heart failure. AU - Wozakowska-Kapłon,Beata, AU - Opolski,Grzegorz, PY - 2003/11/18/pubmed PY - 2004/3/25/medline PY - 2003/11/18/entrez SP - 213 EP - 23 JF - Kardiologia polska JO - Kardiol Pol VL - 59 IS - 9 N2 - BACKGROUND: Loss of atrial systolic function as well as fast and irregular ventricular response result in the impairment of hemodynamic function in patients with atrial fibrillation (AF). AF is considered to be a less efficient cardiac rhythm than sinus rhythm (SR), and accounts for the symptoms of reduced exercise tolerance, such as fatigue, tiredness or dyspnoea. In more severe cases, the hemodynamic alterations can result in heart failure. AIM: To assess exercise performance before and one month after cardioversion of persistent AF. METHODS: We studied 42 patients with mild to moderate clinically stable heart failure and persistent AF (median duration 7 months) with controlled ventricular rate. They underwent submaximal exercise testing 24 hours before cardioversion and one month after cardioversion. Exercise capacity was determined during symptom-limited exercise testing, according to a modified Bruce protocol with peak VO(2) analysis. RESULTS: Thirty-five (83%) patients were successfully cardioverted to SR. One month after cardioversion 29 patients remained in SR (SR group) while 6 had recurrence of AF, and, together with patients with unsuccessful cardioversion, formed the AF group (n=13). Baseline patient characteristics did not differ between the SR and AF groups. Left ventricular ejection fraction (52.7+/-10.2% vs 56.5+/-9.6%, NS) and exercise tolerance (peak VO(2) 19.85+/-3.5 ml/min/kg vs 22.2+/-3,4 ml/kg/min, NS; and exercise duration 9.5+/-3.4 min vs 10.6+/-2.4 min; NS) were similar in both groups before cardioversion. Successful cardioversion resulted in a mean decrease in resting heart rate of 28 beats/minute (94.7+/-10.3 vs 66.7+/-9.7 beats/min, p<0.05), measured 30 days after cardioversion, and a significant improvement in exercise tolerance in the SR group: exercise duration increased from 9.5+/-3.4 min to 13.7+/-3.2 min, p<0.05; and peak oxygen consumption increased from 19.85+/-3.5 ml/min/kg to 32.2+/-3.6 ml/min/kg, p<0.05. No improvement was observed in the AF group. CONCLUSIONS: Restoration of sinus rhythm in patients with persistent AF is associated with a significant improvement in exercise capacity one month after cardioversion. SN - 0022-9032 UR - https://www.unboundmedicine.com/medline/citation/14618198/Improvement_in_exercise_performance_after_successful_cardioversion_in_patients_with_persistent_atrial_fibrillation_and_symptoms_of_heart_failure_ L2 - https://medlineplus.gov/heartfailure.html DB - PRIME DP - Unbound Medicine ER -