Exercise for Atrial Fibrillation

(ACUTE-AF Trial)

Overseen By Matheus Mistura

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Ottawa Heart Institute Research Corporation

Disqualifiers: Routine exercise, Unstable angina, Uncontrolled diabetes, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

36 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how exercise affects symptoms of atrial fibrillation (AF), a heart condition that causes an irregular and often rapid heart rhythm. It compares high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) against a week of no exercise to determine if these workouts can help manage AF symptoms. Individuals who experience AF episodes (either paroxysmal or persistent) and have noticed symptoms in the past month might be suitable candidates. Participants should not already engage in regular exercise routines. As an unphased trial, this study offers a unique opportunity to contribute to understanding how exercise can manage AF symptoms.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that high-intensity interval training (HIIT) is generally safe for people with atrial fibrillation (AF). In one study with 86 participants who had AF, HIIT proved just as effective as moderate-intensity continuous training (MICT) in improving fitness. Participants maintained HIIT for a year, similar to those doing MICT.

Evidence suggests that MICT is usually safe for most people with AF. Although it has not been studied as extensively as HIIT, MICT remains considered safe and beneficial for heart health.

Both HIIT and MICT are well-tolerated and can be safe choices for people with AF. Studies reviewed have reported no major negative effects, which is encouraging for anyone considering joining a trial with these exercise methods. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about exploring exercise as a way to help manage atrial fibrillation (AFib) because it offers a unique, non-pharmaceutical approach to treatment. Unlike typical AFib treatments that often include medication or surgical interventions, high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) focus on improving cardiovascular health through targeted physical activity. These exercise methods could potentially enhance heart function and reduce AFib episodes by strengthening the heart muscle and improving overall fitness. By engaging in structured exercise routines, participants might experience benefits more quickly and with fewer side effects compared to traditional treatments.

What evidence suggests that this trial's exercise treatments could be effective for atrial fibrillation?

This trial will compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on individuals with atrial fibrillation (AF). Studies have shown that both HIIT and MICT can benefit people with AF. Research indicates that HIIT may improve heart and lung fitness, reduce AF symptoms, and enhance quality of life. In a study with 86 AF patients, HIIT proved as effective as MICT in improving physical ability. MICT has also been found to lower AF symptoms and improve fitness and quality of life. Both exercise methods show promise in managing AF symptoms, with HIIT potentially offering slightly greater benefits. Participants in this trial will join either the HIIT group, the MICT group, or a rest group for comparison. ^{1 3 4 6 7}

Who Is on the Research Team?

Jennifer Reed, PhD

Principal Investigator

Ottawa Heart Institute Research Corporation

Are You a Good Fit for This Trial?

This trial is for men and women over 40 with symptomatic atrial fibrillation (AF) who can exercise safely. Participants must have had AF symptoms recently, women should be post-menopausal, and all must understand English or French. Excluded are those already exercising regularly, with unstable heart conditions or severe diabetes, unable to use a smartphone or the internet, or with certain cardiac devices.

Inclusion Criteria

I have felt symptoms in the last 4 weeks.

I have irregular heartbeats that come and go or persist.

Agrees to sign informed consent

Exclusion Criteria

Unable to provide written, informed consent

I cannot or will not follow the three required conditions.

You have a specific type of heart device called an automated external defibrillator, implantable cardioverter defibrillator, or pacemaker.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Exercise Intervention

Participants engage in a randomized crossover study with 1 week of high-intensity interval training (HIIT), 1 week of moderate-intensity continuous training (MICT), and 1 week of rest.

3 weeks

3 sessions per week for HIIT and MICT

Follow-up

Participants are monitored for safety and effectiveness after the exercise intervention, including daily AF status measurement and symptom reporting.

1.5 years

What Are the Treatments Tested in This Trial?

Interventions

• High-intensity interval training (HIIT)
• Moderate-intensity continuous training (MICT)

Trial Overview The study tests how different types of exercise affect short-term changes in AF symptoms. It compares moderate-intensity continuous training (MICT), high-intensity interval training (HIIT), and no vigorous exercise over one week in a randomized crossover design where participants will try each condition.

How Is the Trial Designed?

Group I: Moderate Intensity Continuous Training (MICT) Experimental Treatment 1 Intervention

Participants will do 3 sessions of moderate-intensity continous exercise training over 7 days

Group II: High Intensity Interval Training (HIIT) Experimental Treatment 1 Intervention

Participants will do 3 sessions of high-intensity interval training over 7 days

Group III: Rest Active Control 1 Intervention

Participants will abstain from doing moderate- to high-intensity interval training over 7 days

High-intensity interval training (HIIT) is already approved in European Union, United States for the following indications:

Approved in European Union as High-Intensity Interval Training for:

• Cardiovascular rehabilitation
• Improvement of peak oxygen uptake (VO2 peak)
• Enhancement of physical functioning and quality of life

Approved in United States as High-Intensity Interval Training for:

• Cardiovascular rehabilitation
• Improvement of peak oxygen uptake (VO2 peak)
• Enhancement of physical functioning and quality of life

Who Is Running the Clinical Trial?

Ottawa Heart Institute Research Corporation

Lead Sponsor

Trials

200

Recruited

95,800+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9623436/

Effect of High-Intensity Interval Training in Patients With ... In this randomized clinical trial including 86 individuals with atrial fibrillation, HIIT was as efficacious as MICT in improving functional capacity and ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S1050173824000021

Effects of different exercise methods and intensities on the ... High-intensity interval training (HIIT) shows promise, potentially surpassing MICT, especially in reducing age-related AF susceptibility and improving symptoms ...

3. gavinpublishers.com gavinpublishers.com/article/view/the-application-of-high-intensity-interval--training-in-atrial-fibrillation-a-literature-review

The Application of High Intensity Interval Training in Atrial ... The findings of these studies reveal promising outcomes related to reduced AF symptoms severity, improved aerobic capacity, quality of life and ...

4. ahajournals.org ahajournals.org/doi/10.1161/JAHA.124.040330

Heterogeneous Exercise Responses to High‐Intensity ... Over the past decades, several studies have demonstrated the benefit for HIIT on patients with HF, including increased aerobic capacity, ...

5. researchgate.net researchgate.net/publication/364985533_Effect_of_High-Intensity_Interval_Training_in_Patients_With_Atrial_Fibrillation_A_Randomized_Clinical_Trial

Effect of High-Intensity Interval Training in Patients With ... High-intensity interval training (HIIT) has been shown to elicit greater improvements in functional capacity and QOL compared with moderate to vigorous ...

6. ahajournals.org ahajournals.org/doi/10.1161/JAHA.118.009305

High‐Intensity Interval Training for Patients With ... High‐intensity interval training appears to be relatively safe to conduct in patients with cardiovascular disease, including coronary artery ...

7. jamanetwork.com jamanetwork.com/journals/jamacardiology/fullarticle/2769884

Short-term and Long-term Feasibility, Safety, and Efficacy ... HIIT was feasible and safe, with similar adherence to MICT over 12-month follow-up. These findings support inclusion of HIIT in cardiac ...