Abstract:Objective To investigate the effect of home-based exercise on recurrence of atrial fibrillation (AF) after catheter ablation. Methods This was a single-center, prospective randomized controlled trial. A total of 112 patients diagnosed with AF whose left atrial diameter was less than 50 mm on echocardiography were enrolled and randomly assigned to home-based exercise group or control group (56 patients each). Starting 1 month post-ablation, the home-based exercise group received individualized aerobic exercise regimens based on cardiopulmonary rehabilitation assessment, performed 3 times weekly for 30 min per session, with heart rate maintained at 60%-70% of peak heart rate, for 1 year; the control group maintained their original lifestyle without additional exercise intervention. All patients were followed for 1 year postoperatively. The primary endpoint was defined as AF, atrial flutter, or atrial tachycardia lasting ≥30 s recorded on 24 h Holter monitoring between 4 and 12 months post-ablation. Results Kaplan-Meier survival analysis revealed that the risk of recurrence after catheter ablation for AF was significantly lower in the home-based exercise group than in the control group (log-rank test, P=0.045). Univariate Cox regression analysis demonstrated that home-based exercise reduced the recurrence risk following catheter ablation in patients with AF (hazard ratio [HR] =0.35, 95% confidence interval [95%CI] 0.22-0.98, P=0.045); multivariate Cox regression analysis revealed, after adjusting for confounding factors home-based exercise remained an independent protective factor against post-ablation recurrence of AF (HR=0.29, 95%CI 0.09-0.98, P=0.046). Conclusion Home-based exercise is an independent protective factor against AF recurrence after catheter ablation and should be incorporated into the post-ablation management plan.