• Posted July 30, 2025

Cardiac Rehab Is Safe for Folks With A-Fib, And Might Even Help Ease It

If you’ve had a heart attack or are in heart failure, doctors often prescribe cardiac rehabilitation to strengthen your heart. 

A new study contends that these programs are also appropriate for folks with the common irregular heartbeat known as atrial fibrillation (A-Fib), and may even help treat the condition.

That could be game-changing news: Up till now, some doctors have been reluctant to advise cardiac rehab for patients with A-Fib, worrying that exercise might trigger an A-Fib episode.

However, the study’s authors say A-Fib guidelines should now “reflect this updated evidence base, by recommending [exercise-based cardiac rehabilitation] alongside drug and ablation therapies for patients with [A-Fib]."

The findings were published July 29 in the British Journal of Sports Medicine.

The study noted that up to 12 million Americans are expected to develop A-Fib by 2050. 

The condition occurs when the heart’s upper chambers begin to malfunction and “twitch,” triggering more general heart rhythm dysfunction and causing symptoms such as palpitations, chest pain, fatigue, dizziness and shortness of breath.

A-Fib can also raise the odds for clots that can cause stroke.  

Current treatments involve drugs and an electrical zapping procedure called ablation, to try and correct the dysfunction.

A-Fib often occurs alongside heart attack or heart failure — but might cardiac rehab provoke A-Fib episodes?

The new study aimed to find out. 

It was led by Benjamin Buckley, senior lecturer at the Liverpool Center for Cardiovascular Science in the U.K.

Buckley’s team crunched the data from more than 20 clinical trials. All were focused on patients with A-Fib and conducted between 2006 and 2024. 

Overall, more than 2,000 patients from across the world were included in the analysis, and their health was tracked for an average of 11 months.

All of the patients had been enrolled in some form of cardiac rehab — some programs included exercise-only rehab, while others included a psychological component as well.

Most of the rehab programs involved “moderate intensity” exercise, usually aerobic. Programs lasted anywhere from eight to 24 weeks, with sessions ranging from 15 to 90 minutes each. 

The combined data showed no rise in the risk of death for folks with A-Fib who took part in cardiac rehab. 

In fact, compared to patients who didn’t undergo rehab, people with A-Fib who did saw their symptoms severity drop by an average of 39%, and the frequency and length of their A-Fib episodes fall by 43% and 42%, respectively. 

Patients’ risk of an A-Fib recurrence also fell by almost a third.

Beyond these welcome findings, the analysis also found that the exercise capacity of people with A-Fib rose following cardiac rehab, as did their sense of mental well-being. 

All of these trends persisted regardless of how much rehab was involved, the exact type of A-Fib the patient had or particular patient characteristics, the authors reported. 

What exactly is going on to produce the benefit?

“Exercise training promotes favorable atrial remodeling, including reduced atrial stiffness and fibrosis, which may help limit [conditions favorable for A-Fib], although further research is needed,” Buckley and team said. 

In an accompanying editorial, Dr. Sarandeep Marwaha and Dr. Sanjay Sharma of the Institute of Cardiovascular and Cell Sciences in London said the new findings "provide further compelling evidence that [exercise-based cardiac rehabilitation] significantly benefits patients” with A-Fib. 

“Patients may fear that exercise can trigger [A-Fib] episodes, especially those with underlying heart conditions, and clinicians will often underemphasize exercise guidance and exercise prescriptions due to uncertainty,” the two experts said. “However, most studies evaluating moderate exercise in patients with [A-Fib] have demonstrated safety with a very low risk of adverse events.”

More information

Find out more about atrial fibrillation at the American Heart Association.

SOURCE: British Journal of Sports Medicine, news release, July 29, 2025