Kinesiophobia After Atrial Fibrillation Ablation: Associated Risk Factors and Impacts on Postprocedural Syndrome

Purpose: Exercise-based cardiac rehabilitation (CR) after atrial fibrillation (AF) ablation is beneficial for patients with AF; however, kinesiophobia has been demonstrated to be a significant barrier to CR. The aim of the study was to investigate the perioperative risk factors for kinesiophobia, as well as its impact on postprocedural syndrome after AF ablation. Methods: Consecutive patients with paroxysmal AF who underwent ablation between January 2023 and April 2023 were included. Kinesiophobia and exercise self-efficacy were assessed 48 to 72 hours after ablation. Scheduled follow-up was conducted 1, 2, 3, and 6 months after the procedure. Results: Among the 87 patients enrolled, 54 (62%) suffered from a high level of postoperative kinesiophobia. Patients with kinesiophobia were more likely to suffer from postoperative nonspecific symptoms ( P < .001) and decreased exercise tolerance ( P < .001) during early recovery period. The anesthesia method (OR = 0.05: 95% CI, 0.01-0.17) and preoperative European Heart Rhythm Association (EHRA) score (OR = 6.60: 95% CI, 1.85-26.95) were important risk factors for postoperative kinesiophobia. The anesthesia method and preoperative EHRA score were associated with nonspecific symptoms and decreased exercise tolerance, which is fully mediated by kinesiophobia. Conclusions: Kinesiophobia was significantly correlated with adverse experiences during the early recovery period after AF ablation. The choice of anesthesia, management of AF-related symptoms, and patient education are crucial for reducing kinesiophobia.