Comparing exercise capacity, inflammation and endothelial function following cardioversion between asymptomatic and symptomatic patients with atrial fibrillation

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Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, occurring in 1-2% of the population. Many patients remain asymptomatic, likely leading to an underestimation of the true prevalence of AF. Of particular importance is the similar risk of stroke and adverse health outcomes in the asymptomatic cohort. Catheter ablation has emerged as an effective treatment for symptomatic AF. However, the risk to benefit ratio of an ablation procedure in asymptomatic AF is less established. (i) Examine whether the restoration of sinus rhythm by cardioversion in asymptomatic patients improves exercise capacity to a similar degree as patients with symptomatic AF. (ii) Compare baseline and post-exercise parameters of the prothrombotic state between symptomatic and asymptomatic patients both before after cardioversion (1) We hypothesize that exercise capacity will be similarly impaired in symptomatic and asymptomatic patients and improve following restoration of sinus rhythm following cardioversion. (2) We further hypothesise that: a. acute exercise will elevate the prothrombotic state in both symptomatic and asymptomatic patients and; b. inflammation and endothelial dysfunction will be observed in both patient cohorts and similarly improved following the return of sinus rhythm.

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