The Norwegian Exercise in Atrial Fibrillation Trial

NEXAF

Patient / Population Intervention / Exposition Comparaison Critère de jugement

In 295 inactive adults with non-permanent atrial fibrillation, a 12-month supervised-then-home exercise programme reduced AF burden and AF-specific quality of life at 12 months compared with usual care.

N

295patients

Schéma

multicentre (Trondheim, Bærum/Drammen, Tromsø), open-label, two-arm RCT; 1:1 supervised plus eHealth-based exercise vs usual care; blinded statistical analysis; 12-month follow-up with insertable cardiac monitor

Critère

co-primary: (1) total time in atrial fibrillation (burden, %) measured by insertable cardiac monitor over 12 months; (2) AFEQT overall score at 12 months

Pertinence

2Important — l’un des piliers parmi d’autres.

RésultatAF burden 3.9% vs 7.1% at one year, a 45% relative reduction (P = 0.016), but the co-primary quality-of-life score did not differ (AFEQT +5.6 vs +4.4; P = 0.43). Fitness rose and resting heart rate fell; total hospitalisations were 37% lower and AF-related hospitalisations 46% lower.

Nes BM, et al. Presented at ESC Congress 2026, Hot Line 8, 30 August.

Discussion et critique

Exercise halves the time spent in atrial fibrillation, measured by an implanted monitor rather than by symptoms — the cleanest evidence yet that the arrhythmia itself responds to training. The second co-primary endpoint did not move: patients did not feel better, the same dissociation between rhythm and symptoms that the sham-controlled ablation trial in this session found. Open-label against usual care, 295 patients, and the hospitalisation figures are secondary and unadjusted for multiplicity.