122/A novel 4 pillar model of exercise delivery is well tolerated in arrhythmic patients and could help reduce arrhythmia burden

Introduction: Research has shown that increasing cardiovascular fitness (Skielboe et al., 2017) and reducing body mass (Middeldorp et al., 2018) can reduce the burden of arrhythmias on patients’ health. In addition, if we can reduce other cardiovascular risk factors the prognostic risk of the arrhythmia or other cardiac events progressing is likely to be minimised. In the current study we aim to investigate whether a novel model of exercise delivery is safe and effective in improving the health of patients with arrhythmias. The study included patients with an arrhythmia diagnosed via investigation through a cardiologist or electrophysiologist prior to referral.
Methods: All participants completed a 12-week cardiac rehabilitation programme at CP+R. This involved twice-weekly supervised resistance sessions reaching overload, twice-weekly aerobic training within a prescribed heart rate zone, on-going step-count monitoring and nutritional guidance. Participants underwent pre and post measures of body composition, cardiovascular fitness and metabolic profiling. The programme was overseen and delivered by a Clinical Exercise Specialist with support from a Physiotherapist and Clinic Nurse.
Results: 68 participants (58.3 ± 13.1 years; male = 49, female = 19) were recruited to the programme. Following the 12-week intervention participants experienced a significant reduction in blood pressure (127/79 ± 15/11 mmHg to 117/74 ± 12/10 mmHg; p<0.01). The participants also trended towards reductions in body mass (86.8 ± 19.8 kg to 84.4 ± 18.4 kg; p = 0.48), as well as body fat percentage (32.2 ± 8.1% to 30.6 ± 8.3 %; p=0.27) and improvements in predicted maximal oxygen uptake (34.9 ± 8.7 ml/kg/min to 35.7 ± 11.0 ml/kg/min; p=0.38). There was a 100% adherence to the 12 week-programme.
Conclusions: The current study demonstrates a safe and effective method of reducing cardiovascular risk factors in patients with arrhythmia, this can lead to a reduction in arrhythmia burden. The lack of significant results in the anthropometric and cardiovascular fitness markers would be benefit from investigation over a longer time frame as this current programme length may not have been sufficient to elicit significant physiological changes. Future research should focus on studying this four-pillar model over a longer time frame as well as investigating the specific effects of this programme on arrhythmia sub-types.