Фибрилляция предсердий и фитнес

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Модератор: Pyankov Vasily

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Pyankov Vasily
Сообщения: 5564
Зарегистрирован: Пн ноя 24, 2008 12:59 am
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Фибрилляция предсердий и фитнес

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Impact of CARDIOrespiratory FITness on Arrhythmia Recurrence in Obese Individuals with Atrial Fibrillation: The CARDIO-FIT Study


Abstract


Background
Obesity begets atrial fibrillation (AF). Increased cardiorespiratory fitness is protective against incident AF in obese individuals; however, its effect on AF recurrence or the benefit of cardiorespiratory fitness gain is unknown.

Objectives
Evaluate the role of cardiorespiratory fitness and the incremental benefit of cardiorespiratory fitness improvement on rhythm control in obese individuals with AF.

Methods
Of 1415 consecutive patients with AF, 825 had BMI&#8805;27kg/m2 and were offered risk factor management and participation in a tailored exercise program. After exclusions, 308 patients were included in the analysis. Patients underwent exercise stress testing to determine peak metabolic equivalents (METs). To determine a dose-response, cardiorespiratory fitness was categorized as: low (<85>100%). Impact of cardiorespiratory fitness gain was ascertained by the objective gain in fitness at final follow-up (&#8805;2 METs versus <2 METs). AF rhythm control was determined using 7-day Holter monitoring and AF severity scale questionnaire.

Results
There were no differences in baseline characteristics or follow-up duration between the groups defined by cardiorespiratory fitness. Arrhythmia-free survival with and without rhythm control strategies was greatest in patients with high cardiorespiratory fitness compared to adequate or low cardiorespiratory fitness (p<0.001 for both). AF burden and symptom severity decreased significantly in the group with cardiorespiratory fitness gain &#8805;2 METs as compared to <2 METs group (p<0.001 for all). Arrhythmia-free survival with and without rhythm control strategies was greatest in those with METs gain &#8805;2 compared to those with METs gain <2 in cardiorespiratory fitness (p<0.001 for both). In multivariable analyses, baseline cardiorespiratory fitness (p<0.001), cardiorespiratory fitness gain (p<0.001) and weight-loss (p=0.008) were 4 independent predictors of outcomes. METs gain &#8805;2 in cardiorespiratory fitness resulted in a 2-fold (95% CI:3.4-10.3,p<0.001) greater probability of arrhythmia-free survival.

Conclusion
Cardiorespiratory fitness predicts arrhythmia recurrence in obese individuals with symptomatic AF. Improvement in cardiorespiratory fitness augments the beneficial effects of weight-loss.


J Am Coll Cardiol. 2015;():. doi:10.1016/j.jacc.2015.06.488

http://content.onlinejacc.org/article.a ... id=2348717

P.S. Фитнес и никаких тебе РЧА и антиаритмических препаратов. :)
Пьянков Василий Алексеевич
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