{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T18:42:25Z","timestamp":1785177745285,"version":"3.55.0"},"reference-count":4,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T00:00:00Z","timestamp":1611360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Progression of atrial fibrillation (AF) is associated with worsened prognosis for cardiovascular events and mortality. Exercise-based-cardiac rehabilitation programmes have shown preliminary promise for primary and secondary prevention of AF. Yet, such interventions are typically reserved for patients with acute coronary syndrome or undergoing revascularization. Using a retrospective cohort design, the present study investigated the association of exercise-based cardiac rehabilitation on the progression of paroxysmal to sustained AF, compared to propensity-matched controls. Patients with a diagnosis of paroxysmal AF were compared between those with and without an electronic medical record of exercise-based cardiac rehabilitation within 6-months of diagnosis. Using cox regression models, we ascertained odds of 2-year incidence for AF progression. This cohort of 9808 patients with paroxysmal AF demonstrated that exercise-based cardiac rehabilitation was associated with 26% lower odds of AF progression (odds ratio 0.74, 95% CI 0.66\u20130.83) compared to propensity-matched controls. This beneficial effect seemed to vary across patient subgroups. In conclusion, findings revealed that exercise-based cardiac rehabilitation was associated with significantly lower odds of progression from paroxysmal to sustained AF at 2-years follow-up compared to propensity-matched controls.<\/jats:p>","DOI":"10.3390\/jcm10030435","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T02:07:00Z","timestamp":1611540420000},"page":"435","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Association of Exercise-Based Cardiac Rehabilitation with Progression of Paroxysmal to Sustained Atrial Fibrillation"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1479-8872","authenticated-orcid":false,"given":"Benjamin J. R.","family":"Buckley","sequence":"first","affiliation":[{"name":"Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health &amp; Life Sciences, William Henry Duncan Building, Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool L7 8TX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health &amp; Life Sciences, William Henry Duncan Building, Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool L7 8TX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elnara","family":"Fazio-Eynullayeva","sequence":"additional","affiliation":[{"name":"TriNetX LLC., 25 Cambridge Park Dr #500, Cambridge, MA 02140, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Underhill","sequence":"additional","affiliation":[{"name":"TriNetX LLC., The Leadenhall Building Level 30, 122 Leadenhall Street, London EC3V 4AB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5604-9378","authenticated-orcid":false,"given":"Deirdre A.","family":"Lane","sequence":"additional","affiliation":[{"name":"Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health &amp; Life Sciences, William Henry Duncan Building, Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool L7 8TX, UK"},{"name":"Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dick H. J.","family":"Thijssen","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, Liverpool John Moores University, Liverpool L7 8TX, UK"},{"name":"Department of Physiology, Research Institute for Health Science, Radboud University Medical Centerum, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health &amp; Life Sciences, William Henry Duncan Building, Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool L7 8TX, UK"},{"name":"Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2301","DOI":"10.1161\/STROKEAHA.118.021396","article-title":"Progression from paroxysmal to sustained atrial fibrillation is associated with increased adverse events","volume":"49","author":"Ogawa","year":"2018","journal-title":"Stroke"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Buckley, B.J.R., Lip, G.Y.H., and Thijssen, D.H.J. (2020). The counterintuitive role of exercise in the prevention and cause of atrial fibrillation. Am. J. Physiol. Heart C.","DOI":"10.1152\/ajpheart.00509.2020"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1093\/eurheartj\/ehz897","article-title":"Association between physical activity and risk of incident arrhythmias in 402 406 individuals: Evidence from the UK Biobank cohort","volume":"41","author":"Elliott","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2987","DOI":"10.1093\/eurheartj\/ehx739","article-title":"Targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent atrial fibrillation: Results of the RACE 3 trial","volume":"39","author":"Rienstra","year":"2018","journal-title":"Eur. Heart J."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/3\/435\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:14:24Z","timestamp":1760159664000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/3\/435"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,23]]},"references-count":4,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,2]]}},"alternative-id":["jcm10030435"],"URL":"https:\/\/doi.org\/10.3390\/jcm10030435","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,23]]}}}