Perspective:

Results from epidemiological studies suggest that persistent high-intensity exercise training is associated with a higher risk of incident AF. However, in this randomized study, short-term interval training was associated with improvement in arrhythmia burden in patients with AF. The differences between these studies include the fact that individuals in the current study already had AF, and likely as importantly, performed moderate-intensity (as opposed to vigorous) exercise for a short-term period. The current study adds to an emerging evidence base demonstrating the importance of exercise and weight loss in reducing the AF burden. This study should also exhort clinicians in more vigorously recommending such measures in patients with AF, especially those patients in whom a rhythm strategy is chosen. Antiarrhythmic medications and catheter ablation cannot undo the structural and electrical remodeling that led to AF in the first place. Maintaining a healthy lifestyle seems to be salutary not only in terms of arrhythmia burden, but also in a host of other cardiometabolic measures.