Ap-453071-3 impact of sex on outcomes following aerobic exercise training in patients with symptomatic atrial fibrillation

Aerobic exercise prescription promotes the maintenance of sinus rhythm in patients with atrial fibrillation (AF). There is little data exists on whether this may be modified by patient sex. Compare outcoes between male and female patents amongst a randomized controlled trial of aerobic exercise prescription for patients with symptomatic AF. This study was a prospective, randomized, controlled trial of patients with symptomatic paroxysmal or persistent AF, referred for consideration of AF ablation. Randomization was 1:1 to either aerobic exercise intervention or usual medical care for a period of 6 months with a further 6 months follow-up. The exercise intervention was delivered in a hybrid format of weekly supervised exercise sessions coupled with prescribed home exercise, up to a total of 210 minutes per week. The intervention was led by a clinical exercise physiologist. Management of arrhythmia was at the discretion of a cardiologist blinded to patient randomization. The primary endpoint reported here is recurrent AF without rhythm control strategies. Of the 120 patients enrolled in the study (65±10 years, BMI 30±6, 38% Persistent AF), 51 were female (42.5%). Female patients were less likely to have persistent AF at baseline (19.6%) compared to males (47.8%), had comparable BMI (30.8 v 30.2 kg/m2), were older (68±7 v 63±11 years) and had lower baseline peak oxygen uptake (16±4 v 23±5mL/kg/min, p<0.001). After 12-mnths of follow-up, both male (HR 0.52, 95% CI: 0.29-0.91) and female patients (HR 0.47, 95% CI: 0.23-0.95) in the exercise group had reduced recurrence of AF without anti-arrhythmic medication or AF ablation. Although male and female patients exhibit baseline differences in risk factor profile, aerobic exercise training is equally effective in males and females for the reduction of recurrent arrhythmia amongst patients with symptomatic atrial fibrillation.