Table 1.

Included studies

Study	Inclusion criteria	Intervention: control	Exercise/control	Outcomes
Hegbom 25	Patients with chronic AF,<75 years.	Exercise 8 weeks, three sessions/week. Supervised, 1.25 hours, aerobic exercise: 5 min warm-up, 3×15 min periods of aerobics @ 70%–90% HRmax interrupted by strengthening exercise (back, thighs and stomach), followed by a 5 min cool-down and 15 min of stretching. Sessions completed @ one of two rehabilitation Centres. Control Usual care.	15/15 randomised 13/15 analysed	Heart rate variability Maximal heart rate Resting heart rate Cumulated workload (W) Exercise time max. (min) QoL (SF-36)
Luo 2	Heart failure patients with LVEF <35%. Sub-analysis of those with AF from HF ACTION trial.	Exercise 12 weeks, three sessions/week. Supervised aerobic exercise (walking, treadmill, or cycle ergometer), followed by transition to a home-based exercise programme for an additional 2 years. Control Usual care.	193/189 randomised and analysed	6MWD Peak VO2 QoL (KCCQ) All-cause mortality/ hospitalisation Cardiovascular mortality/HF hospitalisation
Malmo 26	Patients with non-permanent AF (paroxysmal or persistent)	Exercise 12 weeks, three sessions/week. Aerobic (walking/running), 10 min warm-up @ 60%–70% HRpeak, then 4×4 min intervals @ 85%–95% of HRpeak with 3 min of active recovery @ 60%–70% HRpeak between intervals. Control Usual care.	26/25 randomised and analysed	Time in AF AF symptoms and severity Blood pressure Resting heart rate Peak heart rate Cardiac volumes (ejection fraction) QoL (SF-36) Peak VO2 lipid status (TC, HDL, LDL, TG) hsCRP BMI, weight activity
Osbak 27	Adults with permanent AF.	Exercise 12 weeks, three sessions/week, @ 70% maximal exercise capacity (Borg scale scores 14–16). Total exercise duration was 60 min 3, minimum 30 min @ 70% maximal exercise capacity. Control Usual care.	25/24 randomised 24/23 analysed	CO (maximal and resting) Maximal heart rate Resting heart rate Blood pressure Heart rate reserve 6MWD Maximal power (W) QoL (MLHF-Q and SF-36) ANP, NT-pro-BNP Adverse events
Pippa 28	Patients diagnosed with AF at least 3 months prior, and taking anticoagulant treatment for at least 2 months.	Exercise 16 weeks, two sessions/week. 90 min sessions of qi gong training. Qi gong refers to a set of static exercises. Control Usual Care.	22/21 randomised and analysed	6MWD BMI Lipids (TC, HDL) Homocysteine Ejection fraction Adverse events
Risom 29	Consecutive patients planned for treatment with radiofrequency catheter ablation,≥18 years. Paroxysmal or persistent AF.	Exercise 12 weeks, three sessions/week, graduated cardiovascular training based on Borg 15-point scale and strength exercises. Control Usual care.	105/105 randomised*	Peak VO2 Maximal power (W) STS Max. blood pressure QoL (SF-36, HADS) EHRA score Mortality, adverse events
Skielboe 10	Patients with paroxysmal/ persistent AF.	Exercise 12 weeks, two sessions/week, 60 min/session, high Intensity – (80% of maximal RPE). Comparator 12 weeks, two sessions/week, 60 min/session, low Intensity (50% of maximal RPE).	38/38 randomised† 26/29 analysed†	Burden of AF (time spent in AF) Peak VO2 Hospital admissions Adverse events
Wahlstrom 31	Patients with paroxysmal AF, necessitating pharmacological treatment.	Exercise 12 weeks, one session a week, 60 min group session of yoga (Mediyoga) and encouraged to practice at home. Control Usual care.	40/40 randomised 33/36 analysed	QoL (SF-36, EuorQoL-5D) Resting heart rate Blood pressure
Zeren 30	Patients with permanent AF, LVEF >40%.	Exercise 12 weeks, 2×15 min sessions, 7 days/week. Inspiratory muscle training a@ 30% MIP. Control Usual care.	19/19 randomised 17/16 analysed	Pulmonary function Respiratory muscle strength Adverse events

*Different numbers for analysis at different time points for different outcomes.

†Performed ITT analysis and per protocol analysis.

ACR, Albumin: Creatinine ratio; AF, Atrial Fibrillation; ANP, Atrial Natriuretic Peptide; BMI, Body mass index; ERHA, European Heart Rhythm Score; HADS, Hospital anxiety and depression score; HD, High density lipoprotein; HF, Heart failure; KCCQ, Kansas City Cardiomyopathy Questionnaire; LDL, Low density lipoprotein; MLHF-Q, Minnesota living with heart failure questionnaire; 6MWD, 6 minute walk distance; NT-Pro-BNP, N-terminal Pro-Brain Natriuretic Peptide; QoL, Quality of life; RPE, Rate of Perceived Exertion; SF-36, Short form-36; STS, Sit-to stand test; TC, Total cholesterol; TG, Triglycerides; eGFR, estimated Glomerular Filtration Rate; hsCRP, high-sensitive C-reactive protein.