Cardiac prehabilitation, rehabilitation and education in first-time atrial fibrillation (AF) ablation (CREED AF): Study protocol for a randomised controlled trial.

Abstract

Atrial fibrillation (AF) is a common arrhythmia [1–3] and is independently associated with increased morbidity and all-cause mortality [3–8]. Two-thirds of people with AF have at least intermittent symptoms which can be disabling and can markedly impair health-related quality of life (HRQoL) [9, 10]. Furthermore, AF is a growing epidemic due to the ageing population, chronic cardiovascular diseases, and the accumulation of AF related risk factors, such as diabetes, obesity, hypertension, alcohol, and smoking [6, 11, 12]. Current AF management is largely focused on stroke prevention via anticoagulation, and heart failure prevention with ventricular rate or rhythm control strategies (anti-arrhythmic drugs and catheter or surgical ablation) [3, 13] and is a top priority in the UK National Health Service (NHS) long-term plan [14]. Although current strategies can be effective in the short term, long-term success is limited and there is a failure to address key patient outcomes including exercise capacity and HRQoL.