Reversal of Atrial Fibrillation with Exercise
The influence of exercise on atrial fibrillation (AF) has been studied in 20 patients. Age ranged from 36-74. AF was paroxysmal in 12, persistent in 4 and the initial presentation in 4. It was the initial episode in 2 patients, 5 had paroxysmal AF of 2-9 years duration. The duration of the AF prior to exercise was 2-24 hours. None had chest pain, hypotension of left ventricular failure.
7 patients aged 35-74 reverted to sinus rhythm during exercise. 13 aged 36-69 failed to revert, in 7 the exercise had to be stopped due to dyspnoea (3), ischaemic chest pain (2), severe hypertension (1) or a sore leg (1).
The rate of AF varied from 60-160, the duration of exercise until reversion was 6-19 minutes and in all patients the AF reverted when the heart rate exceeded the underlying rate of AF. No patient who failed to revert with exercise did so spontaneously prior to D-C reversion 3 hours to 7 months later.
Conclusion.
Exercise potentially offers a simple out-patient procedure to revert AF to sinus rhythm in some patients, avoiding the necessity for D-C reversion and failure to revert with exercise may predict failure to revert spontaneously within 24-48 hours and allow scheduling of D-C reversion.