Effects of Recumbent Bicycle Exercise on Cardiac Autonomic Responses and Hemodynamics Variables in Patients with Atrial Fibrillation

Seong Dae Kim; Sang Hee Lee; Hee-Hyuk Lee; Il Gyu Jeong

doi:10.15384/kjhp.2019.19.4.248

Korean J Health Promot > Volume 19(4); 2019 > Article

Kim, Lee, Lee, and Jeong: Effects of Recumbent Bicycle Exercise on Cardiac Autonomic Responses and Hemodynamics Variables in Patients with Atrial Fibrillation

Original Article

Korean Journal of Health Promotion 2019;19(4):248-254.

Published online: December 31, 2019

DOI: https://doi.org/10.15384/kjhp.2019.19.4.248

Effects of Recumbent Bicycle Exercise on Cardiac Autonomic Responses and Hemodynamics Variables in Patients with Atrial Fibrillation

Seong Dae Kim¹

, Sang Hee Lee²

, Hee-Hyuk Lee¹

, Il Gyu Jeong¹

¹Department of Sports Science, Hannam University, Daejeon, Korea.

²Department of Cardiology, Pohang Semyung Christianity Hospital, Pohang, Korea.

Corresponding author: Il Gyu Jeong, PhD. Department of Sports Science, Hannam University, 70 Hannam-ro, Daedeok-gu, Daejeon 34430, Korea.
Tel: +82-42-629-7653, Fax: +82-42-629-8402, jig1229@hanmail.net

Received December 11, 2019 Revised January 03, 2020 Accepted January 06, 2020

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background

The purpose of this study is to investigate the safety and efficiency of recumbent bicycle ergometer exercise by observing heart rate variability (HRV) and hemodynamic variables in patients with atrial fibrillation.

Methods

In a balanced crossover study, 13 patients with atrial fibrillation (mean age, 62.2±5.3 years) were asked to perform a bicycle exercise twice, once in the upright position and once in the recumbent position at an angle of 30°, with a 1-week interval between both. The exercise intensity was set initially at 10 W and increased by 15 W every 2 minutes up to 70 W. HRV and hemodynamic variables were measured. All data were analyzed using one-way repeated-measures analysis of variance.

Results

Low-frequency normalization in HRV was increased with no intergroup differences immediately after exercise. The rate pressure product was significantly lower in the recumbent than in the upright position right after exercise (104.8±14.3 vs. 151.8±51.4 mmHg×beats/min×10⁻², P<0.01).

Conclusions

Recumbent exercise improves the safety and efficiency of cardiac rehabilitation for atrial fibrillation patients by reducing myocardial workload without compromising the activation of the autonomic nervous system that regulates cardiac activity.

Keywords: Posture, Exercise, Atrial fibrillation, Hemodynamics

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Table 1

Characteristics of participants

Values are presented as mean±standard deviation or number (%).

Abbreviations: ACE inhibitors, angiotensin -converting enzyme inhibitors; Peak VO₂, peak exercise oxygen consumption.

Table 2

Changes of frequency and time domain in HRV

Values are presented as mean±standard deviation. F values are calculated by one-way repeated-measures analysis of variance.

Abbreviations: G, group; HF norm, high frequency bandwidths normalization; HRV index, heart rate variability index; LF norm, low frequency bandwidths normalization; Recumbent, recumbent group; RMSSD, the root mean square of successive differences; SDNN, standard deviation of the node intervals; T, time; TP, total power; Upright, upright group.

Table 3

Changes of Hemodynamics variables

Values are presented as mean±standard deviation. F values are calculated by one-way repeated-measures analysis of variance.

Abbreviations: CO, cardiac output; G, group; HR, heart rate; Recumbent, recumbent group; RPP, rate pressure product; SBP, systolic blood pressure; SV, stroke volume; SVR, systemic vascular resistance; T, time; Upright, upright group.