Atrial Fibrillation Status and Physical Rehabilitation in Older Patients With Acute Decompensated Heart Failure: An Analysis From the REHAB‐HF Trial

Abstract

Background The REHAB‐HF (Rehabilitation Therapy in Older Acute Heart Failure Patients) trial demonstrated that a transitional, tailored, progressive rehabilitation intervention improved physical function, 6‐minute walk distance, frailty, quality‐of‐life, and depression in older patients hospitalized for acute decompensated heart failure. This analysis assessed the impact of atrial fibrillation (AF) on intervention benefits. Methods and Results Of 349 enrolled patients hospitalized for acute decompensated heart failure (mean age 72.7±8.1 years), 176 (50.4%) had AF. Participants were randomly assigned to 12‐week rehabilitation intervention or attention control. The primary outcome was Short Physical Performance Battery score at 3 months. Participants with AF were older (74.4±8.3 versus 70.8±7.5, P0.05). Interaction P values for 3‐month outcomes by AF status were not significant (P>0.1). No significant differences were observed in deaths, all‐cause rehospitalizations, or heart failure hospitalizations at 6 months. Conclusions In older, hospitalized patients with acute decompensated heart failure, the presence of AF did not significantly affect the benefit of the rehabilitation intervention on physical function and quality of life. The intervention appears safe and effective regardless of AF status. Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT02196038.

Keywords

• arrhythmia
• atrial fibrillation
• frailty
• heart failure
• rehabilitation intervention