Effects of cardiac rehabilitation on atrial fibrillation recurrence, mortality, hospitalization, and exercise capacity: a systematic review and meta-analysis.
T, S., C, S., G, L., Y, J., D, L., L, Q., C, M., G, W., L, Z., & Y, S. (2026). Effects of cardiac rehabilitation on atrial fibrillation recurrence, mortality, hospitalization, and exercise capacity: a systematic review and meta-analysis.. PeerJ. https://doi.org/10.7717/peerj.21422
T S, C S, G L, Y J, D L, L Q, et al. Effects of cardiac rehabilitation on atrial fibrillation recurrence, mortality, hospitalization, and exercise capacity: a systematic review and meta-analysis.. PeerJ. 2026; doi: 10.7717/peerj.21422
T S, C S, G L, et al. Effects of cardiac rehabilitation on atrial fibrillation recurrence, mortality, hospitalization, and exercise capacity: a systematic review and meta-analysis.[J]. PeerJ. 2026. DOI: 10.7717/peerj.21422.
@article{t2026,
author = {Shen T and Shi C and Li G and Jiang Y and Li D and Qian L and Ma C and Wang G and Zheng L and Shen Y},
title = {Effects of cardiac rehabilitation on atrial fibrillation recurrence, mortality, hospitalization, and exercise capacity: a systematic review and meta-analysis.},
journal = {PeerJ},
year = {2026},
doi = {10.7717/peerj.21422},
note = {PMID: 42376039},
}
TY - JOUR AU - Shen T AU - Shi C AU - Li G AU - Jiang Y AU - Li D AU - Qian L AU - Ma C AU - Wang G AU - Zheng L AU - Shen Y TI - Effects of cardiac rehabilitation on atrial fibrillation recurrence, mortality, hospitalization, and exercise capacity: a systematic review and meta-analysis. T2 - PeerJ PY - 2026 DO - 10.7717/peerj.21422 AN - PMID:42376039 ER -
BACKGROUND: Cardiac rehabilitation (CR) may benefit patients with atrial fibrillation (AF) in areas such as exercise capacity. However, evidence regarding its impact on AF recurrence, a key clinical outcome, remains inconsistent. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of CR on AF recurrence, all-cause mortality, hospitalization, and exercise capacity in patients with AF. METHODS: We systematically searched the Cochrane Library, PubMed, and Embase from January 1, 1980, to April 20, 2026. Two reviewers independently screened studies, extracted data, and assessed risk of bias. A total of 1,550 patients from 11 RCTs were included in the meta-analysis based on the predefined inclusion and exclusion criteria. RESULTS: Pooled analysis demonstrated a significant reduction in AF recurrence among patients receiving CR compared with controls (risk ratio (RR) 0.77, 95% confidence interval (CI) [0.67-0.89], p = 0.0003, I 2 = 20%). However, this effect was not statistically significant in the exploratory subgroup of patients post-ablation (RR 0.86, 95% CI [0.69-1.07], p = 0.17, I 2 = 0%). Exercise capacity, measured via the 6-minute walking test, significantly improved (weighted mean difference (WMD) 32.22, 95% CI [21.22-43.23], p < 0.00001, I 2 = 0%). No significant differences were observed in all-cause mortality (RR 1.04, 95% CI [0.74-1.46], p = 0.81, I 2 = 0%), hospitalization rates (RR 1.00, 95% CI [0.85-1.19], p = 0.97, I 2 = 0%), or the composite outcome of mortality and hospitalization (RR 1.01, 95% CI [0.90-1.14], p = 0.83, I 2 = 0%). CONCLUSIONS: CR is associated with a reduction in AF recurrence in the overall AF population, though this benefit was not observed in the exploratory subgroup of patients post-ablation. It significantly improves exercise capacity but does not appear to affect mortality or hospitalization rates. Further high-quality randomized trials are needed to evaluate the benefits and potential risks of CR across different types of AF.