{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:21:38Z","timestamp":1792686098990,"version":"4.5.0"},"reference-count":34,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Patients with atrial fibrillation (AF) experience poor functional capacity and quality of life (QOL). High-intensity interval training (HIIT) has been shown to elicit greater improvements in functional capacity and QOL compared with moderate to vigorous intensity continuous training (MICT) in other cardiovascular populations, yet HIIT remains understudied in AF.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare the effects of 12 weeks of HIIT and MICT-based cardiovascular rehabilitation (CR) on functional capacity and general QOL in patients with persistent and permanent AF. Disease-specific QOL, resting heart rate (HR), time in AF, and physical activity (PA) levels were also assessed.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This randomized clinical trial, conducted between November 17, 2015, and February 4, 2020, at a tertiary-care cardiovascular health center in Ottawa, Canada, recruited 94 patients with persistent and permanent AF.<\/jats:p><\/jats:sec>Interventions<\/jats:title>High-intensity interval training (23 minutes: two 8-minute interval training blocks of 30-second work periods at 80%-100% of peak power output interspersed with 30-second recovery) or CR (60 minutes: continuous aerobic conditioning within 67%-95% of peak HR and 12-16 of 20 ratings of perceived exertion) twice weekly for 12 weeks.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcomes were changes in functional capacity (6-minute walk test [6MWT] distance) and general QOL (Short Form 36) from baseline to 12 weeks\u2019 follow-up. Secondary outcomes included changes in disease-specific QOL (Atrial Fibrillation Severity Scale), resting HR, time in AF, and PA levels. An intention-to-treat analysis was used to compare changes between groups.<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 94 patients who consented, 86 participated (mean [SD] age, 69 [7] years; 57 [66.3%] men). No significant differences in improvements in 6MWT distance (mean [SD], 21.3 [34.1] vs 13.2 [55.2] m; P<\/jats:italic>\u2009=\u2009.42) and general QOL (Physical Component Summary, 0.5\u2009[6.1] vs 1.1 [4.9] points; P<\/jats:italic>\u2009=\u2009.87) between HIIT and CR were observed. No significant differences in improvements in disease-specific QOL (AF symptoms: \u22121.7 [4.3] vs \u22121.5 [4] points, P<\/jats:italic>\u2009=\u2009.59), resting HR (\u22123.6 [10.6] vs \u22122.9 [12.4] beats per minute, P<\/jats:italic>\u2009=\u2009.63), and moderate to vigorous PA levels (37.3 [93.4] vs 14.4 [125.7] min\/wk; P<\/jats:italic>\u2009=\u2009.35) between HIIT and CR were detected. Participants attended a mean (SD) of 18.3 (6.1) (75.1%) HIIT sessions and 20.0 (4.5) (83.4%) CR sessions (P<\/jats:italic>\u2009=\u2009.36).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this randomized clinical trial, twice-weekly 23-minute HIIT was as efficacious as twice-weekly 60-minute CR in improving functional capacity, general and disease-specific QOL, resting HR, and PA levels in patients with persistent and permanent AF.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT02602457<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.39380","type":"journal-article","created":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T15:33:14Z","timestamp":1667230394000},"page":"e2239380","source":"Crossref","is-referenced-by-count":47,"title":["Effect of High-Intensity Interval Training in Patients With Atrial Fibrillation"],"prefix":"10.1001","volume":"5","author":[{"given":"Jennifer L.","family":"Reed","sequence":"first","affiliation":[{"name":"University of Ottawa Heart Institute, Ottawa, Ontario, Canada"},{"name":"University of Ottawa, Faculty of Health Sciences, School of Human Kinetics, Ottawa, Ontario, Canada"},{"name":"Deprtment of Medicine, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasuku","family":"Terada","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sol","family":"Vidal-Almela","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, Ottawa, Ontario, Canada"},{"name":"University of Ottawa, Faculty of Health Sciences, School of Human Kinetics, Ottawa, Ontario, Canada"},{"name":"Research Unit on Nutrition and Metabolism, Institut de recherche de l\u2019H\u00f4pital Montfort, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather E.","family":"Tulloch","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, Ottawa, Ontario, Canada"},{"name":"Deprtment of Medicine, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus","family":"Mistura","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H.","family":"Birnie","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, Ottawa, Ontario, Canada"},{"name":"Deprtment of Medicine, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George A.","family":"Wells","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, Ottawa, Ontario, Canada"},{"name":"Deprtment of Medicine, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girish M.","family":"Nair","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, Ottawa, Ontario, Canada"},{"name":"Deprtment of Medicine, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harleen","family":"Hans","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberley L.","family":"Way","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, Ottawa, Ontario, Canada"},{"name":"Deakin University, School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Chirico","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, Ottawa, Ontario, Canada"},{"name":"Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carley D.","family":"O\u2019Neill","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew L.","family":"Pipe","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, Ottawa, Ontario, Canada"},{"name":"Deprtment of Medicine, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2022,10,31]]},"reference":[{"key":"zoi221115r1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjqcco\/qcaa061","article-title":"Global, regional, and national prevalence, incidence, mortality, and risk factors for atrial fibrillation, 1990-2017: results from the Global Burden of Disease Study 2017.","author":"Dai","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"issue":"12","key":"zoi221115r2","doi-asserted-by":"publisher","first-page":"1847","DOI":"10.1016\/j.cjca.2020.09.001","article-title":"The 2020 Canadian Cardiovascular Society\/Canadian Heart Rhythm Society comprehensive guidelines for the management of atrial fibrillation.","volume":"36","author":"Andrade","year":"2020","journal-title":"Can J Cardiol"},{"issue":"5","key":"zoi221115r3","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1093\/europace\/euq109","article-title":"An international survey of physician and patient understanding, perception, and attitudes to atrial fibrillation and its contribution to cardiovascular disease morbidity and mortality.","volume":"12","author":"Aliot","year":"2010","journal-title":"Europace"},{"key":"zoi221115r4","first-page":"1","article-title":"Avoiding permanent atrial fibrillation: treatment approaches to prevent disease progression.","volume":"10","author":"Shukla","year":"2014","journal-title":"Vasc Health Risk Manag"},{"issue":"2","key":"zoi221115r5","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2018-000880","article-title":"Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials.","volume":"5","author":"Smart","year":"2018","journal-title":"Open Heart"},{"issue":"10","key":"zoi221115r6","doi-asserted-by":"publisher","first-page":"S284","DOI":"10.1016\/j.cjca.2018.07.014","article-title":"The effects of cardiac rehabilitation in patients with atrial fibrillation: a systematic review.","volume":"34","author":"Reed","year":"2018","journal-title":"Can J Cardiol"},{"key":"zoi221115r7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2147\/OAJSM","article-title":"High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis.","volume":"9","author":"Hannan","year":"2018","journal-title":"Open Access J Sports Med"},{"issue":"2","key":"zoi221115r8","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1097\/HCR.0000000000000156","article-title":"Effect of high-intensity interval versus continuous exercise training on functional capacity and quality of life in patients with coronary artery disease: a randomized clinical trial.","volume":"36","author":"Jaureguizar","year":"2016","journal-title":"J Cardiopulm Rehabil Prev"},{"issue":"14","key":"zoi221115r9","doi-asserted-by":"publisher","first-page":"1096","DOI":"10.1001\/archinternmed.2012.2198","article-title":"Six-minute walk test as a prognostic tool in stable coronary heart disease: data from the Heart and Soul study.","volume":"172","author":"Beatty","year":"2012","journal-title":"Arch Intern Med"},{"issue":"12","key":"zoi221115r10","doi-asserted-by":"publisher","first-page":"1644","DOI":"10.1016\/j.mayocp.2014.07.011","article-title":"Prognostic value of exercise capacity in patients with coronary artery disease: the FIT (Henry Ford Exercise Testing) project.","volume":"89","author":"Hung","year":"2014","journal-title":"Mayo Clin Proc"},{"issue":"5","key":"zoi221115r11","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1249\/FIT.0000000000000705","article-title":"Practical recommendations for high-intensity interval training for adults with cardiovascular disease.","volume":"25","author":"Way","year":"2021","journal-title":"Health Fit J"},{"issue":"5","key":"zoi221115r12","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1161\/CIRCULATIONAHA.115.018220","article-title":"Aerobic interval training reduces the burden of atrial fibrillation in the short term: a randomized trial.","volume":"133","author":"Malmo","year":"2016","journal-title":"Circulation"},{"key":"zoi221115r13","doi-asserted-by":"publisher","first-page":"g1687","DOI":"10.1136\/bmj.g1687","article-title":"Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide.","volume":"348","author":"Hoffmann","year":"2014","journal-title":"BMJ"},{"issue":"1","key":"zoi221115r15","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1081\/COPD-200050527","article-title":"Minimal clinically important differences in the six-minute walk test and the incremental shuttle walking test.","volume":"2","author":"Wise","year":"2005","journal-title":"COPD"},{"issue":"2","key":"zoi221115r16","doi-asserted-by":"publisher","first-page":"141","DOI":"10.2165\/00019053-199915020-00003","article-title":"Determining clinically important differences in health status measures: a general approach with illustration to the Health Utilities Index Mark II.","volume":"15","author":"Samsa","year":"1999","journal-title":"Pharmacoeconomics"},{"key":"zoi221115r17","first-page":"839","article-title":"Measuring quality of life and symptom severity in patients with atrial fibrillation.","volume":"21","author":"Maglio","year":"1998","journal-title":"Pacing Clin Electrophysiol"},{"key":"zoi221115r18","article-title":"Physical activity of Canadian adults: accelerometer results from the 2007-2009 Canadian Health Measures Survey.","author":"Colley","year":"2011","journal-title":"Health Rep"},{"issue":"5","key":"zoi221115r19","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/j.jsams.2011.04.003","article-title":"Validation and comparison of ActiGraph activity monitors.","volume":"14","author":"Sasaki","year":"2011","journal-title":"J Sci Med Sport"},{"issue":"4","key":"zoi221115r20","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/j.physio.2011.11.003","article-title":"The 6-minute walk test in outpatient cardiac rehabilitation: validity, reliability and responsiveness\u2014a systematic review.","volume":"98","author":"Bellet","year":"2012","journal-title":"Physiotherapy"},{"key":"zoi221115r21","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/1477-7525-2-26","article-title":"Sample size and power estimation for studies with health related quality of life outcomes: a comparison of four methods using the SF-36.","volume":"2","author":"Walters","year":"2004","journal-title":"Health Qual Life Outcomes"},{"issue":"1","key":"zoi221115r23","doi-asserted-by":"publisher","first-page":"41","DOI":"10.17705\/1CAIS","article-title":"A two-step approach for transforming continuous variables to normal: implications and recommendations for IS research.","volume":"28","author":"Templeton","year":"2011","journal-title":"Comm Assoc Inform Syst"},{"key":"zoi221115r24","doi-asserted-by":"publisher","first-page":"740","DOI":"10.3389\/fphys.2020.00740","article-title":"Efficacy of physical exercise on the quality of life, exercise ability, and cardiopulmonary fitness of patients with atrial fibrillation: a systematic review and meta-analysis.","volume":"11","author":"Shi","year":"2020","journal-title":"Front Physiol"},{"issue":"2","key":"zoi221115r25","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1378\/chest.123.2.387","article-title":"The 6-min walk test: a quick measure of functional status in elderly adults.","volume":"123","author":"Enright","year":"2003","journal-title":"Chest"},{"key":"zoi221115r26","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s12955-015-0282-9","article-title":"Living on a knife edge\u2014the daily struggle of coping with symptomatic cardiac arrhythmias.","volume":"13","author":"Withers","year":"2015","journal-title":"Health Qual Life Outcomes"},{"issue":"4","key":"zoi221115r27","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1080\/02640414.2019.1706829","article-title":"Can high-intensity interval training improve physical and mental health outcomes? a meta-review of 33 systematic reviews across the lifespan.","volume":"38","author":"Martland","year":"2020","journal-title":"J Sports Sci"},{"key":"zoi221115r28","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1016\/j.ahj.2016.08.013","article-title":"Cardiac rehabilitation versus usual care for patients treated with catheter ablation for atrial fibrillation: results of the randomized CopenHeartRFA trial.","volume":"181","author":"Risom","year":"2016","journal-title":"Am Heart J"},{"issue":"8","key":"zoi221115r29","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1253\/circj.70.965","article-title":"Rate control and quality of life in patients with permanent atrial fibrillation: the Quality of Life and Atrial Fibrillation (QOLAF) Study.","volume":"70","author":"Tsuneda","year":"2006","journal-title":"Circ J"},{"issue":"5","key":"zoi221115r30","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1002\/tsm2.v3.5","article-title":"Exercise-based cardiac rehabilitation improves physical fitness in patients with permanent atrial fibrillation\u2014a randomized controlled study.","volume":"3","author":"Borland","year":"2020","journal-title":"Transl Sports Med"},{"issue":"2","key":"zoi221115r31","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1097\/HCR.0000000000000565","article-title":"Adherence to high-intensity interval training in cardiac rehabilitation: a review and recommendations.","volume":"41","author":"Taylor","year":"2021","journal-title":"J Cardiopulm Rehabil Prev"},{"key":"zoi221115r32","doi-asserted-by":"publisher","DOI":"10.1177\/2047487320907748","article-title":"Lessons learned from community- and home-based physical activity programs: a narrative review of factors influencing women\u2019s participation in cardiac rehabilitation.","author":"Vidal-Almela","year":"2020","journal-title":"Eur J Prev Cardiol"},{"issue":"13","key":"zoi221115r33","doi-asserted-by":"publisher","first-page":"e262","DOI":"10.1161\/CIR.0000000000000440","article-title":"Sedentary behavior and cardiovascular morbidity and mortality: a science advisory from the American Heart Association.","volume":"134","author":"Young","year":"2016","journal-title":"Circulation"},{"issue":"10","key":"zoi221115r34","doi-asserted-by":"publisher","first-page":"1678","DOI":"10.1016\/j.cjca.2021.04.019","article-title":"Exercise targets in the 2020 CCS Guidelines for the management of patients with atrial fibrillation.","volume":"37","author":"Reed","year":"2021","journal-title":"Can J Cardiol"},{"key":"zoi221115r14","volume-title":"Canadian Guidelines for Cardiac Rehabilitation and Cardiovascular Disease Prevention","author":"Canadian Association of Cardiac Rehabilitation","year":"2009","edition":"3rd ed"},{"key":"zoi221115r22","volume-title":"SF-36 Health Survey Manual and Interpretation Guide","author":"Ware","year":"1993"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2797984\/reed_2022_oi_221115_1666636840.84498.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T15:33:24Z","timestamp":1667230404000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2797984"}},"subtitle":["A Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2022,10,31]]},"references-count":34,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10,3]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.39380","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,31]]}}}