One-Year High‑Intensity Exercise Cuts Atrial Fibrillation Time by Nearly Half

Overview

• The NEXAF randomized trial presented at ESC Congress 2026 found a 45% relative reduction in AF burden over one year, with exercise patients spending 3.9% of monitored time in AF versus 7.1% in usual care (absolute reduction 3.4 percentage points, p=0.016).
• Researchers reported about 37% fewer total hospital admissions and roughly 46% fewer AF‑related hospital admissions among participants assigned to the exercise program compared with usual care.
• The intervention combined eight supervised high‑intensity sessions during the first month with a year of home‑based, digitally supported training and used implantable cardiac monitors to continuously quantify AF burden.
• Despite lower AF time and better fitness and resting heart rate, there was no significant improvement in AF‑specific quality of life at one year and no change in standard cardiovascular risk factors, and the trial population (mean age 64, 30% women) may limit generalizability.
• Investigators describe the hybrid model as feasible to deliver with modest staff and say broader uptake could close a major rehabilitation gap in AF care, but they stress the need for peer‑reviewed publication, replication, and longer‑term data before routine implementation.