Effect of an Exercise and Nutrition Program on Quality of Life in Patients With Atrial Fibrillation: The Atrial Fibrillation Lifestyle Project (ALP)

Background: Studies of separate exercise and weight loss interventions have reported improvements in quality of life (QoL) or reduction in atrial fibrillation (AF) burden. We investigated the impact of a structured exercise, nutrition, and risk-factor-modification program on QoL and AF burden. Methods: In this trial, 81 successive patients with body mass index > 27 kg/m(2) and nonpermanent AF were randomized to an intervention (n = 41) or control group (n = 40). The intervention consisted of cardiovascular risk management and a 6-month nutrition and exercise program, followed by a 6-month maintenance program. All participants received usual AF care. The primary end-point was QoL at 6 and 12 months. Results: At 6 months, we observed improved QoL among patients in the intervention group, relative to that among control-group patients (intervention (I) n = 34, control (C) n = 38) in the 36-item Short Form Survey Instrument scores on the subscales of vitality (I: 13.2 +/- 20.4; C: 1.0 +/- 14.9, P < 0.001), social functioning (I: 14.7 +/- 24.1; C: 2.4 +/- 21.2, P = 0.018), emotional well-being (I: 5.5 +/- 14.1; C: e1.0 +/- 13.3, P = 0.017), and general health perceptions (I: 8.1 +/- 12.3; C: 2.7 +/- 13.3, P = 0.009). At the 6-month follow-up, improvement in the scores on the subscales of vitality (P = 0.021) and emotional wellbeing (P = 0.036) remained significant. The burden of AF as measured by Holter monitor and Toronto AF symptom score was not significantly changed. Conclusions: A structured exercise and nutrition program resulted in significant sustained improvements in QoL, without reduction in AF burden. This type of program may provide an additional treatment for people with impaired QoL due to AF.