{"id":"b8d8eb4285dc","type":"article","url":"https://hartvaat.nl/2017/04/04/inspanningstraining-bij-chronisch-hartfalen-met-atriumfibrilleren/","title":"Inspanningstraining bij chronisch hartfalen met atriumfibrilleren","title_en":"Exercise Training in Patients With Chronic Heart Failure and Atrial Fibrillation.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":["acuut-hartfalen","vrouwen"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2017.01.032","source_url":"https://doi.org/10.1016/j.jacc.2017.01.032","authors":["Nancy Luo","Peter Merrill","Kishan S Parikh","David J Whellan","Ileana L Piña","Mona Fiuzat","William E Kraus","Dalane W Kitzman","Steven J Keteyian","Christopher M O'Connor","Robert J Mentz"],"significance":6,"published":"2017-04-04","source_date":"2017-04-04","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/af-en-hartfalen/","https://hartvaat.nl/kennis/atriumfibrilleren/af-bij-ouderen/"],"congress":"","summary_en":"This study evaluated the safety and efficacy of aerobic exercise training in patients with the dual burden of chronic heart failure and atrial fibrillation, a common but understudied combination in rehabilitation research.","created":"2026-07-03T10:26:38Z","updated":"2026-07-03T18:38:32Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar het effect van gestructureerde inspanningstraining bij patiënten met de combinatie chronisch hartfalen en atriumfibrilleren — twee aandoeningen die vaak coëxisteren.","abstract_original":"BACKGROUND: The safety and efficacy of aerobic exercise in heart failure (HF) patients with atrial fibrillation (AF) has not been well evaluated. OBJECTIVES: This study examined whether outcomes with exercise training in HF vary according to AF status. METHODS: HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training) randomized 2,331 ambulatory HF patients with ejection fraction ≤35% to exercise training or usual care. We examined clinical characteristics and outcomes (mortality/hospitalization) by baseline AF status (past history of AF or AF on baseline electrocardiogram vs. no AF) using adjusted Cox models and explored an interaction with exercise training. We assessed post-randomization AF events diagnosed via hospitalizations for AF and reports of serious arrhythmia caused by AF. RESULTS: Of 2,292 patients with baseline rhythm data, 382 (17%) had AF, 1,602 (70%) had sinus rhythm, and 308 (13%) had \"other\" rhythm. Patients with AF were older and had lower peak Vo2. Over a median follow-up of 2.6 years, AF was associated with a 24% per year higher rate of mortality/hospitalization (hazard ratio [HR]: 1.53; 95% confidence interval [CI]: 1.34 to 1.74; p < 0.001) in unadjusted analysis; this did not remain significant after adjustment (HR: 1.15; 95% CI: 0.98 to 1.35; p = 0.09). There was no significant difference in AF event rates by randomized treatment assignment in the overall population or by baseline AF status (all p > 0.10). There was no interaction between AF and exercise training on measures of functional status or clinical outcomes (all p > 0.10). CONCLUSIONS: AF in patients with chronic HF was associated with older age, reduced exercise capacity at baseline, and a higher overall rate of clinical events, but not a differential response to exercise training for clinical outcomes or changes in exercise capacity. (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training [HF-ACTION]; NCT00047437)."}