Nishimura Saori, Tanaka Ryou, Kamikawa Shigeshi, Waki Isao, Yamashita Daiki, Tabita Natsumi, Higashiya Shunichi, Yamaji Hirosuke, Murakami Takashi, Kusachi Shozo
Division of Cardiovascular Rehabilitation, Okayama Heart Clinic, Okayama, Japan.
Division of Cardiovascular Medicine & Intervention, Okayama, Japan.
J Exerc Rehabil. 2024 Apr 26;20(2):83-90. doi: 10.12965/jer.2448056.028. eCollection 2024 Apr.
The determination of precise exercise intensity is essential for effective exercise rehabilitation. The Borg rating of perceived exertion category ratio (CR) scale is utilized to prescribe an appropriate level of exertion intensity. A Borg CR of approximately 13 coincides with the ventilatory aerobic threshold (VAT). Patients with atrial fibrillation (AF) exhibit various symptoms. We hypothesized that the workload at Borg CR13 (Borg CR13-Watt) differs from the workload at the VAT level (VAT-Watt) in AF patients with restored sinus rhythm (SR) following ablation. Accordingly, the relationship between Borg CR13-Watt and VAT-Watt was studied in patients with restored SR. Cardiopulmonary exercise testing (CPET) was performed at 101±88 days after ablation in 150 patients using a bicycle ergometer. No adverse events were observed during CPET. Borg CR13-Watt was significantly higher than VAT-Watt (67.2±27.8 Watt vs. 54.7±17.6 Watt, <0.0001). Borg CR13-Watt showed significant linear regression with VAT-Watt (regression coefficient, 0.49, <0.01; correlation coefficient, 0.80, <0.01). Higher Borg CR13-Watt was associated with greater differences between Borg CR13-Watt and VAT-Watt (ΔWatt). The Bland-Altman plot showed nonconcordance between the two. Male sex, use of antiarrhythmic drugs, and smoking had contributed to the increased ΔWatt. Duration from ablation to time of CPET did not correlate with ΔWatt. Therefore, Borg CR13-Watt did not coincide with VAT-Watt in patients with restored SR. Higher Borg CR13-Watt was associated with greater ΔWatt. Prescribing exertion intensity as determined solely by perceived exertion is inadequate. CPET is required to determine the precise exercise intensity in AF patients with restored SR after ablation.
确定精确的运动强度对于有效的运动康复至关重要。采用Borg自觉用力程度类别比率（CR）量表来规定适当的运动强度水平。Borg CR约为13与通气有氧阈值（VAT）相符。心房颤动（AF）患者表现出各种症状。我们假设，在消融后恢复窦性心律（SR）的AF患者中，Borg CR13时的工作量（Borg CR13 - 瓦特）与VAT水平时的工作量（VAT - 瓦特）不同。因此，对恢复SR的患者研究了Borg CR13 - 瓦特与VAT - 瓦特之间的关系。在150例患者消融后101±88天使用自行车测力计进行心肺运动试验（CPET）。CPET期间未观察到不良事件。Borg CR13 - 瓦特显著高于VAT - 瓦特（67.2±27.8瓦特对54.7±17.6瓦特，<0.0001）。Borg CR13 - 瓦特与VAT - 瓦特呈显著线性回归（回归系数，0.49，<0.01；相关系数，0.80，<0.01）。较高的Borg CR13 - 瓦特与Borg CR13 - 瓦特和VAT - 瓦特之间的较大差异（Δ瓦特）相关。Bland - Altman图显示两者不一致。男性、使用抗心律失常药物和吸烟导致Δ瓦特增加。从消融到CPET的时间与Δ瓦特无关。因此，在恢复SR的患者中，Borg CR13 - 瓦特与VAT - 瓦特不相符。较高的Borg CR13 - 瓦特与较大的Δ瓦特相关。仅根据自觉用力程度确定运动强度是不够的。需要进行CPET以确定消融后恢复SR的AF患者的精确运动强度。
