The effects of high-intensity interval training on glucose variability and symptom severity in patients with atrial fibrillation and diabetes: a pilot randomized controlled trial
Bibliographic record
Abstract
Abstract Background Atrial fibrillation (AF) is the most common heart rhythm disorder. Type 2 diabetes (T2D) increases a risk of developing AF and is present in approximately 20% of patients with non-permanent AF (paroxysmal and persistent AF). Many patients with T2D have high blood glucose levels and high glucose variability (GV). Greater GV is independently associated with inflammation, oxidative stress, and autonomic nervous system dysfunction, all of which contribute to the underlying pathophysiology of AF and AF symptom severity. GV has also been associated with poorer quality of life (QoL) in patients with T2D. Exercise improves GV, and high-intensity interval training (HIIT) has emerged as a superior and time-efficient approach to improve GV. However, the effects of HIIT on GV, AF symptom severity, and AF-related QoL in patients with AF living with T2D remain unknown. Purposes This pilot randomized controlled trial compared the impact of HIIT and no exercise training (Control) on GV (primary outcome), AF symptom severity, and AF-related QoL in patients with non-permanent AF living with T2D. The associations between GV and AF symptom severity and QoL were also examined. Methods Eligible patients had diagnosed non-permanent AF and T2D, and were ≥40 years of age, non-smokers, with resting heart rates ≤110 bpm, and no contraindications to performing high-intensity exercise. Included participants were randomized to a 4-week supervised HIIT program or Control. The HIIT group exercised thrice weekly for 12 weeks. Each HIIT session included 16x30-seconds high-intensity intervals at 80-100% of peak power output interspersed with 30-seconds active recovery. At baseline (prior to randomization) and follow-up (after the intervention), participants’ glucose concentrations were measured over three days using a continuous glucose monitoring system, on which percent coefficient of variation (%CV) was calculated for GV. Participants also completed the AF Severity Scale (AFSS) and AF Effect on Quality of Life (AEFQT) questionnaires. Results Due to recruitment challenges imposed by the COVID-19 pandemic, fewer than anticipated participants (N=11 vs. N=36, age: 70±6 years, 25% females) were randomised into HIIT (n=6) or Control (n=5). There were no differences between HIIT and Control in changes in GV (Baseline [B] 20.0±2.5 to follow-up [FU] 18.9±7.9 % vs. B: 21.9±5.5 to FU: 21.5±6.8 %, time x group interaction effect: p=0.988), AFEQT (B: 87.7±7.4 to FU: 88.8±11.5 points vs. B: 68.6±9.9 to FU: 80.5±9.6 points, interaction effect: p=0.123), or AFSS (B: 9.1±2.9 to FU: 9.3±2.1 vs. B: 18.2±6.1 vs. FU: 18.2±6.6 points, interaction effect: p=0.801). No significant correlations were found between GV and AF symptom severity or AF-related QoL. Conclusions Four weeks of HIIT did not improve GV, AF symptom severity or AF-related QoL in patients with non-permanent AF and T2D. However, these findings should be interpreted with caution given the smaller than desired sample size.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".