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

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
Received December 11, 2019       Revised January 03, 2020       Accepted January 06, 2020
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.
REFERENCES
REFERENCES
1. Osbak PS, Mourier M, Kjaer A, Henriksen JH, Kofoed KF, Jensen GB. A randomized study of the effects of exercise training on patients with atrial fibrillation. Am Heart J 2011;162(6):1080-1087.
[Article] [PubMed]
2. Hegbom F, Stavem K, Sire S, Heldal M, Orning OM, Gjesdal K. Effects of short-term exercise training on symptoms and quality of life in patients with chronic atrial fibrillation. Int J Cardiol 2007;116(1):86-92.
[Article] [PubMed]
3. Lee SR, Choi EK, Han KD, Cha MJ, Oh S. Trends in the incidence and prevalence of atrial fibrillation and estimated thromboembolic risk using the CHA2DS2-VASc score in the entire Korean population. Int J Cardiol 2017;236:226-231.
[Article] [PubMed]
4. Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Houston Miller N, Hubbard VS, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63(25 Pt B):2960-2984.
[PubMed]
5. Malmo V, Nes BM, Amundsen BH, Tjonna AE, Stoylen A, Rossvoll O, et al. Aerobic interval training reduces the burden of atrial fibrillation in the short term: a randomized trial. Circulation 2016;133(5):466-473.
[Article] [PubMed]
6. Egaña M, Columb D, O'Donnell S. Effect of low recumbent angle on cycling performance, fatigue, and V·O(2) kinetics. Med Sci Sports Exerc 2013;45(4):663-673.
[Article] [PubMed]
7. Kim SD, Jeong IG, Koh YS, Lee HH. Effects of recumbent angle during cycling on cerebral blood flow velocity and rate pressure product during exercise and recovery. Korean J Health Promot 2019;19(3):155-160.
[Article]
8. Egaña M, O'Riordan D, Warmington SA. Exercise performance and VO2 kinetics during upright and recumbent high-intensity cycling exercise. Eur J Appl Physiol 2010;110(1):39-47.
[Article] [PubMed]
9. Bonzheim SC, Franklin BA, DeWitt C, Marks C, Goslin B, Jarski R, et al. Physiologic responses to recumbent versus upright cycle ergometry, and implications for exercise prescription in patients with coronary artery disease. Am J Cardiol 1992;69(1):40-44.
[Article] [PubMed]
10. Bettoni M, Zimmermann M. Autonomic tone variations before the onset of paroxysmal atrial fibrillation. Circulation 2002;105(23):2753-2759.
[Article] [PubMed]
11. Fioranelli M, Piccoli M, Mileto GM, Sgreccia F, Azzolini P, Risa MP, et al. Analysis of heart rate variability five minutes before the onset of paroxysmal atrial fibrillation. Pacing Clin Electrophysiol 1999;22(5):743-749.
[Article] [PubMed]
12. Lombardi F, Colombo A, Basilico B, Ravaglia R, Garbin M, Vergani D, et al. Heart rate variability and early recurrence of atrial fibrillation after electrical cardioversion. J Am Coll Cardiol 2001;37(1):157-162.
[Article] [PubMed]
13. Selig SE, Carey MF, Menzies DG, Patterson J, Geerling RH, Williams AD, et al. Moderate-intensity resistance exercise training in patients with chronic heart failure improves strength, endurance, heart rate variability, and forearm blood flow. J Card Fail 2004;10(1):21-30.
[PubMed]
14. Malik M. Heart rate variability: standards of measurement, physiological interpretation, and clinical use: task force of the European Society of Cardiology and the North American Society for Pacing and Electrophysiology. Ann Noninvasive Electrocardiol 1996;1(2):151-181.

15. Kusunose K, Yamada H, Hotchi J, Bando M, Nishio S, Hirata Y, et al. Prediction of future overt pulmonary hypertension by 6-min walk stress echocardiography in patients with connective tissue disease. J Am Coll Cardiol 2015;66(4):376-384.
[Article] [PubMed]
16. Gladwell VF, Fletcher J, Patel N, Elvidge LJ, Lloyd D, Chowdhary S, et al. The influence of small fibre muscle mechanoreceptors on the cardiac vagus in humans. J Physiol 2005;567(Pt 2):713-721.
[Article] [PubMed] [PMC]
17. Parekh A, Lee CM. Heart rate variability after isocaloric exercise bouts of different intensities. Med Sci Sports Exerc 2005;37(4):599-605.
[Article] [PubMed]
18. Egaña M, Ryan K, Warmington SA, Green S. Effect of body tilt angle on fatigue and EMG activities in lower limbs during cycling. Eur J Appl Physiol 2010;108(4):649-656.
[Article] [PubMed]
19. Kim SD, Kim MW, Kim SK, Jeong IG. The effects of recumbent bicycle ergometer exercise on cerebral blood flow velocity and BP-based arterial stiffness index. J Sport Leis Stud 2018;74(1):587-597.
[Article]
20. American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription: Wolters Kluwer Health. 9th ed. Baltimore: Lippincott Williams & Wilkins; 2013. p. 243-244.

Table 1
Characteristics of participants
kjhp-19-248-i001

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
kjhp-19-248-i002

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
kjhp-19-248-i003

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.

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