Affective disorder has not been considered appropriately in patients with atrial fibrillation (AF) representing a chronic disorder with reduced quality of life. Adequate ventricular rate (VR) control in permanent atrial fibrillation (AF) is not easy to accomplish. The aim was to assess whether regular moderate physical activity elevates the parasympathetic tone to the atrioventricular node and decreases VR during permanent AF but also improves psychic wellbeing.

10 patients (59±10y) with permanent AF underwent moderate physical exercise (45min walking/jogging, 2/week). To analyze VR control, we performed Holter-ECG recordings, physical exercise treadmill tests, and stepwise lactate tests before, during and after 4 months of training. Psychiatric interviews and psychometric examinations of mood and quality of life (SKID, BDI, HAM-D, SF-36) were obtained, too.

Out of 10 patients, six revealed a previous psychiatric history, four subclinical depressive symptoms and one a depressive syndrome. After training there were significant (p<0.05) improvements with decrease in VR (24 hours, exercise) and increase of lactate threshold (exercise), accompanied by improved general health perceptions in 7/8 quality of life dimensions. Enhanced global physical health was significantly higher in case of more pronounced depressive symptoms (r=0.86; p<0.01). Importantly, in three patients reductions/terminations of cardiac drugs could be undertaken.

Physical training should be accounted for VR control during AF. Regarding the high prevalence of affective symptoms in our AF patients, bodily-oriented rehabilitation might minimize comorbid chronic affective disorder.

This work was partly financed by the European research project ‘MyHeart’ (6th framework, IST 507816).