High-Intensity Aerobic Lifelong Training--AF
| Status: | Recruiting |
|---|---|
| Conditions: | Atrial Fibrillation |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - 65 |
| Updated: | 6/15/2018 |
| Start Date: | May 1, 2018 |
| End Date: | October 2019 |
| Contact: | Lin Yee Chen, MD,MBBS,MS |
| Email: | chenx484@umn.edu |
| Phone: | 612-625-4401 |
High-Intensity Interval Training and Moderate-Intensity Continuous Training in Reducing Atrial Fibrillation Burden
This study is a single-center RCT. Potential subjects with symptomatic non-permanent AF will
be enrolled to determine the effect of sprint interval training (SIT) in comparison to
moderate-intensity continuous training (MICT) and non-exercise control in reducing AF burden.
The Investigators will enroll 60 patients during the first 12 months of the study. Baseline
data collection will be conducted during the first month after enrollment. After baseline
data collection, subjects will be randomized (1:1:1) to SIT vs. MICT vs. non-exercise
controls. The exercise training will last for 3 months followed by final data collection
which will be completed in 1 month.
be enrolled to determine the effect of sprint interval training (SIT) in comparison to
moderate-intensity continuous training (MICT) and non-exercise control in reducing AF burden.
The Investigators will enroll 60 patients during the first 12 months of the study. Baseline
data collection will be conducted during the first month after enrollment. After baseline
data collection, subjects will be randomized (1:1:1) to SIT vs. MICT vs. non-exercise
controls. The exercise training will last for 3 months followed by final data collection
which will be completed in 1 month.
Atrial fibrillation (AF) is the most common heart rhythm abnormality in the general
population. Current recommended methods to maintain sinus rhythm or reduce AF burden (% time
a person is in AF) in patients with non-permanent AF are costly and ineffective. Hence, there
is an urgent need to discover novel inexpensive strategies to reduce AF burden. It is
well-established that regular aerobic exercise reduces cardiovascular morbidity and
mortality; however, adherence to regular exercise is poor rendering it an ineffective public
health strategy. Evidence is emerging to suggest that traditional moderate-intensity
continuous training (MICT) and high-intensity interval training (HIIT) may be associated with
lower AF burden. Compared with traditional MICT, HIIT is possibly more time-efficient; hence,
it may promote adherence. Since lack of time is the most common reason for poor adherence to
regular exercise, the time-efficiency of HIIT holds promise to be a "game-changer". However,
many knowledge gaps remain. First, HIIT has never been compared directly with MICT in
relation to AF burden; thus, whether HIIT is comparable or superior to MICT is unknown.
Second, the time commitment required for a "conventional" HIIT program (120 mins/week) is not
substantially less than the recommended MICT (150 mins/week); hence, it is doubtful that it
can be a real "game-changer" in terms of promoting adherence. Third, HIIT performed using a
cycle ergometer is a safer alternative to the treadmill in older adults, but has not been
evaluated in patients with AF. Finally, mechanisms underlying the salutary benefits of
exercise in relation to AF burden remain unknown. To address these knowledge gaps, the
investigators will evaluate an innovative HIIT program—sprint interval training (SIT)—using a
cycle ergometer that only requires 10 minutes per session and 30 minutes per week, in
contrast to the "conventional" HIIT program that requires 40 minutes per session and 120
minutes per week. In this pilot randomized controlled trial (RCT), the investigators will
randomize 60 subjects with non-permanent AF (1:1:1) to SIT vs. MICT vs. no exercise control.
At enrollment, these subjects will undergo heart rhythm monitoring by a non-invasive
ambulatory heart rhythm monitor, V02 max testing, assessment of cardiac size and function by
cardiac MRI, and assessment of AF symptom severity; these measures will be repeated at 3
months.
population. Current recommended methods to maintain sinus rhythm or reduce AF burden (% time
a person is in AF) in patients with non-permanent AF are costly and ineffective. Hence, there
is an urgent need to discover novel inexpensive strategies to reduce AF burden. It is
well-established that regular aerobic exercise reduces cardiovascular morbidity and
mortality; however, adherence to regular exercise is poor rendering it an ineffective public
health strategy. Evidence is emerging to suggest that traditional moderate-intensity
continuous training (MICT) and high-intensity interval training (HIIT) may be associated with
lower AF burden. Compared with traditional MICT, HIIT is possibly more time-efficient; hence,
it may promote adherence. Since lack of time is the most common reason for poor adherence to
regular exercise, the time-efficiency of HIIT holds promise to be a "game-changer". However,
many knowledge gaps remain. First, HIIT has never been compared directly with MICT in
relation to AF burden; thus, whether HIIT is comparable or superior to MICT is unknown.
Second, the time commitment required for a "conventional" HIIT program (120 mins/week) is not
substantially less than the recommended MICT (150 mins/week); hence, it is doubtful that it
can be a real "game-changer" in terms of promoting adherence. Third, HIIT performed using a
cycle ergometer is a safer alternative to the treadmill in older adults, but has not been
evaluated in patients with AF. Finally, mechanisms underlying the salutary benefits of
exercise in relation to AF burden remain unknown. To address these knowledge gaps, the
investigators will evaluate an innovative HIIT program—sprint interval training (SIT)—using a
cycle ergometer that only requires 10 minutes per session and 30 minutes per week, in
contrast to the "conventional" HIIT program that requires 40 minutes per session and 120
minutes per week. In this pilot randomized controlled trial (RCT), the investigators will
randomize 60 subjects with non-permanent AF (1:1:1) to SIT vs. MICT vs. no exercise control.
At enrollment, these subjects will undergo heart rhythm monitoring by a non-invasive
ambulatory heart rhythm monitor, V02 max testing, assessment of cardiac size and function by
cardiac MRI, and assessment of AF symptom severity; these measures will be repeated at 3
months.
Inclusion Criteria:
- : Patients with symptomatic non-permanent AF and aged 18-65 years who are sedentary
(activity ≤0.5 hours/week of regular exercise) and seen by Dr. Chen or his cardiology
colleagues at Clinics and Surgery Center (CSC), other Fairview cardiology clinics, and
University of Minnesota Medical Center (UMMC). Patients will be screened and enrolled
by a research coordinator.
Exclusion Criteria:
- Individuals lacking the capacity to consent for themselves will not be included,
previous open heart surgery, previous catheter ablation for AF, LVEF <45%, significant
cardiac valve disease, coronary heart disease without complete revascularization,
implanted cardiac electronic device, or GFR <30 mL/min/1.73 m2
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