Exercise Training in Patients With Heart Failure and Permanent Atrial Fibrillation

Effect of Exercise Training in Patients With Heart Failure and Permanent Atrial Fibrillation

The positive effect of physical training in patients with heart failure (HF) has been increasingly established. However, the presence of atrial fibrillation (AF), mainly in its permanent form, makes the clinical condition of the patients more compromised.

The positive effect of physical training in patients with heart failure (HF) has been increasingly established. However, the presence of atrial fibrillation (AF), mainly in its permanent form, makes the clinical picture of these patients more compromised. The literature has not yet demonstrated studies involving indication of physical exercise therapy when AF is associated with HF. Thus, the hypothesis is that physical training improves functional capacity, cerebral oxygenation, autonomic aspects, vascular aspects, cardiac function, plasma markers, quality of life and cognitive function of these patients.

Inclusion Criteria:

• Patients with clinically stable NYHA class II to III heart failure with permanent atrial fibrillation (AF);
• Left ventricular ejection fraction ≤40%;
• Patients refractory and / or no indication of the treatment of reversal to the rhythm;
• Patients in optimization specific drug therapy for HF and AF.

Exclusion Criteria:

• High-frequency ventricular response;
• Neuromuscular / neuropathy disease;
• Physical and mental impairment;
• Chronic obstructive pulmonary disease;
• Diabetes mellitus;
• Decompensated arterial hypertension;
• Autonomic neuropathy;
• Recent myocardial infarction (<6 months);
• Ventricular arrhythmias;
• Atrial flutter;
• Renal failure;
• Use implantable electronic cardiac device or indication for implantation;
• Pregnancy;
• NYHA Functional Class IV;
• Resting heart rate <55 bpm;
• Wolff Parkinson White Syndrome;
• Thyroid dysfunction;
• Unstable angina;
• Recent history of thromboembolic event;
• Inability to sign the consent form;
• Participation in regular physical training program;
• Use of alcoholic beverages.