Dataset Information

A case series of acute responses to high-intensity interval training in four males with permanent atrial fibrillation.

ABSTRACT:

Background

Atrial fibrillation (AF) is a serious medical condition and a burgeoning patient population. Chronic exercise training, including high-intensity interval training (HIIT), has been shown to improve symptoms and quality of life in patients with AF. Yet, the acute responses to HIIT in this population remain understudied, leaving clinicians and patients hesitant about prescribing and engaging in high-intensity exercise, respectively.

Case summary

This case series describes acute exercise responses [i.e. power output, heart rate (HR), blood pressure (BP), ratings of perceived exertion (RPE), symptoms] to 10 weeks (3 days/week) of HIIT. Participants were four white males (58-80 years old) with permanent AF, co-morbidities (diabetes, coronary artery disease, Parkinson's disease), and physical limitations. The increases in HR and BP during HIIT were modest across all participants, regardless of age and medication use. Differences in RPE were observed; the oldest participant perceived the sessions as more challenging despite a lower HR response. All patients complied with the HIIT prescription of 80-100% of peak power output by week 4. No adverse events were reported.

Discussion

Patients' concerns regarding high-intensity exercise may discourage them from participating in HIIT, our results demonstrated no abnormal HR or BP (e.g. hypotension) responses during HIIT or cool-down. These findings align with the typical exercise responses noted in other cardiovascular populations. Notwithstanding the high metabolic demands of HIIT, male patients with permanent AF tolerated HIIT without problem. Further investigation of HIIT as an approach to enable those with AF to recover physical capacity and minimize symptomatology is warranted.

SUBMITTER: Vidal-Almela S

PROVIDER: S-EPMC9366644 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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A case series of acute responses to high-intensity interval training in four males with permanent atrial fibrillation.

Vidal-Almela Sol S Terada Tasuku T Cole Christie A CA O'Neill Carley D CD Comeau Katelyn K Marçal Isabela R IR Pipe Andrew L AL Reed Jennifer L JL

European heart journal. Case reports 20220803 8

<h4>Background</h4>Atrial fibrillation (AF) is a serious medical condition and a burgeoning patient population. Chronic exercise training, including high-intensity interval training (HIIT), has been shown to improve symptoms and quality of life in patients with AF. Yet, the acute responses to HIIT in this population remain understudied, leaving clinicians and patients hesitant about prescribing and engaging in high-intensity exercise, respectively.<h4>Case summary</h4>This case series describes ...[more]

PMID: 35965609

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Project description:ImportancePatients with atrial fibrillation (AF) experience poor functional capacity and quality of life (QOL). High-intensity interval training (HIIT) has been shown to elicit greater improvements in functional capacity and QOL compared with moderate to vigorous intensity continuous training (MICT) in other cardiovascular populations, yet HIIT remains understudied in AF.ObjectiveTo compare the effects of 12 weeks of HIIT and MICT-based cardiovascular rehabilitation (CR) on functional capacity and general QOL in patients with persistent and permanent AF. Disease-specific QOL, resting heart rate (HR), time in AF, and physical activity (PA) levels were also assessed.Design, setting, and participantsThis randomized clinical trial, conducted between November 17, 2015, and February 4, 2020, at a tertiary-care cardiovascular health center in Ottawa, Canada, recruited 94 patients with persistent and permanent AF.InterventionsHigh-intensity interval training (23 minutes: two 8-minute interval training blocks of 30-second work periods at 80%-100% of peak power output interspersed with 30-second recovery) or CR (60 minutes: continuous aerobic conditioning within 67%-95% of peak HR and 12-16 of 20 ratings of perceived exertion) twice weekly for 12 weeks.Main outcomes and measuresThe primary outcomes were changes in functional capacity (6-minute walk test [6MWT] distance) and general QOL (Short Form 36) from baseline to 12 weeks' follow-up. Secondary outcomes included changes in disease-specific QOL (Atrial Fibrillation Severity Scale), resting HR, time in AF, and PA levels. An intention-to-treat analysis was used to compare changes between groups.ResultsOf the 94 patients who consented, 86 participated (mean [SD] age, 69 [7] years; 57 [66.3%] men). No significant differences in improvements in 6MWT distance (mean [SD], 21.3 [34.1] vs 13.2 [55.2] m; P = .42) and general QOL (Physical Component Summary, 0.5 [6.1] vs 1.1 [4.9] points; P = .87) between HIIT and CR were observed. No significant differences in improvements in disease-specific QOL (AF symptoms: -1.7 [4.3] vs -1.5 [4] points, P = .59), resting HR (-3.6 [10.6] vs -2.9 [12.4] beats per minute, P = .63), and moderate to vigorous PA levels (37.3 [93.4] vs 14.4 [125.7] min/wk; P = .35) between HIIT and CR were detected. Participants attended a mean (SD) of 18.3 (6.1) (75.1%) HIIT sessions and 20.0 (4.5) (83.4%) CR sessions (P = .36).Conclusions and relevanceIn this randomized clinical trial, twice-weekly 23-minute HIIT was as efficacious as twice-weekly 60-minute CR in improving functional capacity, general and disease-specific QOL, resting HR, and PA levels in patients with persistent and permanent AF.Trial registrationClinicalTrials.gov Identifier: NCT02602457.

Project description:Ten healthy male participants were recruited and successfully completed all preliminary testing and the two exercise bouts (Figure 1A). This randomized crossover design permitted signaling responses to workload- and duration-matched HIIT and MICT exercise to be mapped and interrogated within the same participant. Baseline whole-body anthropometric and blood glucose and lipid measurements confirmed these participants (age 25.4 ± 3.2 y; BMI 23.5 ± 1.6 kg/m2) were metabolically healthy, and maximal exercise capacity testing confirmed they were recreationally active but relatively untrained (relative V̇O2 peak 37.9 ± 5.2) in line with our recruitment strategy to maximize detection of skeletal muscle signaling responses to exercise (Figure 1B). Peak power output (Wpeak; 207.5 ± 40.3 W) was used to prescribe the relative work-matched intensities for HIIT and MICT. Lean mass from the DXA scan and resting metabolic rate (Figure 1B) were used to prescribe a standardized meal for each participant to consume prior to each exercise trial day. Following consumption of a standardized dinner meal the night before the HIIT or MICT exercise trial, blood and skeletal muscle biopsy samples were collected in the fasted state at baseline and at 5 min and 10 min of each respective exercise intensity. Participants completing the acute bout of HIIT, which consisted of 10 min total of 1-min ‘on’ intervals at 85 ± 0.1% of individual Wpeak (176 ± 34 W) and 1-min ‘off’ intervals at 50 W, displayed increased plasma lactate concentrations at 5 and 10 min of exercise relative to pre-exercise baseline (Figure 1C; P < 0.0001 and P < 0.001, respectively; main effect of time P < 0.0001) and no changes in plasma glucose (Figure 1D). In response to total work- and duration-matched acute bout of MICT at 55 ± 2% individual Wpeak (113 ± 17 W), participants displayed increased plasma lactate concentrations at 5 and 10 min of exercise versus baseline (Figure 1C; P < 0.001; main effect of time P < 0.0001) and no changes in plasma glucose (Figure 1D), with a main effect of higher plasma lactate levels in response to HIIT (Figure 1C; P < 0.05). To map the signaling networks regulated by HIIT and MICT, proteins from each skeletal muscle biopsy sample were extracted, digested to peptides with trypsin, isobarically labelled prior to phosphopeptide enrichment, fractionation and LC-MS/MS phosphoproteomic analysis (Figure 2A).

Project description:This study analyzed whether 100- and 200-m interval training (IT) in swimming differed regarding temporal, perceptual, and physiological responses. The IT was performed at maximal aerobic velocity (MAV) until exhaustion and time spent near to maximalVO2 peak oxygen uptake (⩒O2peak), total time limit (tLim), peak blood lactate [La-] peak, ⩒O2 kinetics (⩒O2K), and rate of perceived exertion (RPE) were compared between protocols. Twelve swimmers (seven males 16.1 ± 1.1 and five females 14.2 ± 1 years) completed a discontinuous incremental step test for the second ventilatory threshold (VT2), ⩒O2peak, and MAV assessment. The swimmers subsequently completed two IT protocols at MAV with 100- and 200-m bouts to determine the maximal ⩒O2 (peak-⩒O2) and time spent ≥VT2, 90, and 95% of ⩒O2peak for the entire protocols (IT100 and IT200) and during the first 800-m of each protocol (IT8x100 and IT4x200). A portable apparatus (K4b2) sampled gas exchange through a snorkel and an underwater led signal controlled the velocity. RPE was also recorded. The Peak-⩒O2 attained during IT8x100 and IT4x200 (57.3 ± 4.9 vs. 57.2 ± 4.6 ml·kg-1·min-1) were not different between protocols (p = 0.98) nor to ⩒O2peak (59.2 ± 4.2 ml·kg-1·min-1, p = 0.37). The time constant of ⩒O2K (24.9 ± 8.4 vs. 25.1 ± 6.3-s, p = 0.67) and [La-] peak (7.9 ± 3.4 and 8.7 ± 1.5 mmol·L-1, p = 0.15) also did not differ between IT100 and IT200. The time spent ≥VT2, 90, and 95%⩒O2peak were also not different between IT8x100 and IT4x200 (p = 0.93, 0.63, and 1.00, respectively). The RPE for IT8x100 was lower than that for IT4x200 (7.62 ± 2 vs. 9.5 ± 0.7, p = 0.01). Both protocols are considered suitable for aerobic power enhancement, since ⩒O2peak was attained with similar ⩒O2K and sustained with no differences in tLim. However, the fact that only the RPE differed between the IT protocols suggested that coaches should consider that nx100-m/15-s is perceived as less difficult to perform compared with nx200-m/30-s for the first 800-m when managing the best strategy to be implemented for aerobic power training.

Project description:PurposeTo compare the effects of six weeks of high intensity interval training (HIIT) vs continuous moderate intensity training (MIT) for improving body composition, insulin sensitivity (SI), blood pressure, blood lipids, and cardiovascular fitness in a cohort of sedentary overweight or obese young men. We hypothesized that HIIT would result in similar improvements in body composition, cardiovascular fitness, blood lipids, and SI as compared to the MIT group, despite requiring only one hour of activity per week compared to five hours per week for the MIT group.Methods28 sedentary overweight or obese men (age, 20 ± 1.5 years, body mass index 29.5 ± 3.3 kg/m2) participated in a six week exercise treatment. Participants were randomly assigned to HIIT or MIT and evaluated at baseline and post-training. DXA was used to assess body composition, graded treadmill exercise test to measure cardiovascular fitness, oral glucose tolerance to measure SI, nuclear magnetic resonance spectroscopy to assess lipoprotein particles, and automatic auscultation to measure blood pressure.ResultsA greater improvement in VO2peak was observed in MIT compared to HIIT (11.1% vs 2.83%, P = 0.0185) in the complete-case analysis. No differences were seen in the intention to treat analysis, and no other group differences were observed. Both exercise conditions were associated with temporal improvements in % body fat, total cholesterol, medium VLDL, medium HDL, triglycerides, SI, and VO2peak (P < 0.05).ConclusionParticipation in HIIT or MIT exercise training displayed: 1) improved SI, 2) reduced blood lipids, 3) decreased % body fat, and 4) improved cardiovascular fitness. While both exercise groups led to similar improvements for most cardiometabolic risk factors assessed, MIT led to a greater improvement in overall cardiovascular fitness. Overall, these observations suggest that a relatively short duration of either HIIT or MIT training may improve cardiometabolic risk factors in previously sedentary overweight or obese young men, with no clear advantage between these two specific regimes (Clinical Trial Registry number NCT01935323).Trial registrationClinicalTrials.gov NCT01935323.

Dataset Information

A case series of acute responses to high-intensity interval training in four males with permanent atrial fibrillation.

Background

Case summary

Discussion

Publications

A case series of acute responses to high-intensity interval training in four males with permanent atrial fibrillation.

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