Tele-Rehabilitation After Catheter Ablation in Patients With Atrial Fibrillation

Effects of Remotely Supervised Cardiac Tele-Rehabilitation in Patients With Atrial Fibrillation After Catheter Ablation: A Single-Blind Randomized Controlled Trial

This study aims to investigate the effects of remotely supervised cardiac telerehabilitation in patients with atrial fibrillation who have undergone catheter ablation. Participants will be randomly assigned to a cardiac telerehabilitation group or a control group. The telerehabilitation group will receive a 12-week remotely supervised exercise program in addition to standard care, consisting of aerobic, strengthening, and stretching exercises. The control group will receive standard care and general exercise guidance without an individualized exercise program. Functional exercise capacity, muscle strength, arterial stiffness, heart rate variability, quality of life, physical activity, balance, cognitive function, anxiety and depression, and atrial fibrillation recurrence will be evaluated.

This is a single-blind, randomized controlled study involving patients with atrial fibrillation who have undergone catheter ablation. Participants meeting the eligibility criteria will be informed about the study and will provide written informed consent before participation.

Participants will be randomly allocated to either a remotely supervised cardiac telerehabilitation group or a control group. The cardiac telerehabilitation group will receive standard care plus a 12-week remotely supervised exercise program consisting of aerobic, strengthening, and stretching exercises. The program will be performed three days per week for a total of 36 sessions, with each session lasting approximately 45-60 minutes.

Aerobic exercise will initially be performed at moderate intensity, corresponding to 40-60% of heart rate reserve according to the Karvonen method and a perceived exertion of 4-6 on the Modified Borg Scale. Exercise intensity and duration will be progressively increased according to individual tolerance. Strengthening exercises will be performed using elastic resistance bands, with exercise intensity monitored using the Modified Borg Scale.

Exercise sessions will be conducted remotely by a physiotherapist using synchronous video-conferencing platforms or applications. Participants will use a Polar H10 chest heart rate sensor and a sports watch during exercise sessions. Exercise data will be uploaded to the PolarBeat platform and monitored remotely by the physiotherapist.

The control group will receive standard care and general information regarding the benefits of exercise and appropriate physical activity recommendations. Participants in the control group will be encouraged to achieve 150 minutes of moderate physical activity per week but will not receive an individualized exercise training program.

Assessments will include functional exercise capacity, muscle strength, handgrip strength, arterial stiffness, heart rate variability, anxiety and depression, atrial fibrillation-specific quality of life, physical activity, balance and fall risk, cognitive function, and atrial fibrillation recurrence. Adherence to the telerehabilitation program will also be recorded.

Inclusion Criteria:

• Aged 50-75 years.
• Diagnosed with atrial fibrillation and treated with catheter ablation.
• Have a smartphone or computer compatible with the digital equipment provided for the study.
• Have access to the Internet.
• Provide written informed consent to participate in the study.

Exclusion Criteria

• Presence of a non-cardiovascular condition (orthopedic or neurological) that limits participation in exercise.
• Acute heart failure, cancer, or worsening of a comorbid condition within the previous 3 months that may affect the assessment or intervention.
• Severe cognitive impairment.
• Unwillingness to participate in the study.