Tele-Rehabilitation After Catheter Ablation in Patients With Atrial Fibrillation

Distance walked during the 6-minute walk test, measured in meters, as an indicator of functional exercise capacity.

Maximum isometric muscle strength will be assessed using a hand-held dynamometer. Bilateral knee extension, shoulder flexion, shoulder abduction, elbow flexion, and elbow extension strength will be measured; the best value will be recorded in kilograms.

Handgrip strength will be assessed using a Jamar hand dynamometer. Measurements will be performed three times for each hand at 5-second intervals, and the best value will be recorded in kilograms.

Carotid-Femoral Pulse Wave Velocity (cfPWV)

Augmentation Index (AIx) will be assessed noninvasively using the SphygmoCor XCEL device and reported as a percentage (%).

SDNN(ms) will be assessed using a Polar H10 heart rate sensor and Kubios HRV software from a 3-minute resting recording obtained with the participant in the supine position.

RMSSD(ms) will be assessed using a Polar H10 heart rate sensor and Kubios HRV software from a 3-minute resting recording obtained with the participant in the supine position.

Low-frequency (LF) power(ms²) will be assessed using a Polar H10 heart rate sensor and Kubios HRV software from a 3-minute resting recording obtained with the participant in the supine position.

High-frequency (HF) power(ms²) will be assessed using a Polar H10 heart rate sensor and Kubios HRV software from a 3-minute resting recording obtained with the participant in the supine position.

The LF/HF ratio will be calculated using Kubios HRV software from a 3-minute resting recording obtained with the participant in the supine position.

The Atrial Fibrillation Effect on Quality-of-Life Questionnaire (AFEQT) will be used to assess atrial fibrillation-specific health-related quality of life. The total score ranges from 0 to 100, with higher scores indicating better health-related quality of life.

Physical activity level will be objectively assessed using a pedometer. Participants will wear the sensor during all waking hours, except during showering and swimming, for 7 consecutive days. Daily step counts and sensor wearing times will be recorded in an activity diary. Physical activity will be assessed during the first 7 days after baseline assessment and during the final 7 days following completion of the 12-week intervention.

The anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A) will be used to assess anxiety symptoms. The score ranges from 0 to 21, with higher scores indicating greater anxiety symptom severity.

The depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) will be used to assess depressive symptoms. The score ranges from 0 to 21, with higher scores indicating greater depressive symptom severity

Cognitive function will be assessed using the Montreal Cognitive Assessment (MoCA). The MoCA evaluates attention and concentration, executive functions, memory, language, visuospatial skills, abstraction, calculation, and orientation. The total score ranges from 0 to 30, with higher scores indicating better cognitive function.

Atrial fibrillation recurrence will be assessed by a cardiologist using 12-lead electrocardiography and 24-hour Holter monitoring. Atrial fibrillation recurrence will be defined as documented atrial fibrillation lasting more than 30 seconds.

Adherence to the telerehabilitation program will be calculated as the percentage of completed exercise sessions out of the 36 prescribed sessions. Participants will be categorized according to session attendance as adherent (>80%), partially adherent (20%-80%), or non-adherent (<20%).

Sway Index will be assessed during the eyes-open condition on a firm surface using the Modified Clinical Test of Sensory Interaction on Balance (M-CTSIB) performed on the Biodex Balance System. Higher Sway Index values indicate greater postural sway and poorer postural stability.

Sway Index will be assessed during the eyes-closed condition on a firm surface using the Modified Clinical Test of Sensory Interaction on Balance (M-CTSIB) performed on the Biodex Balance System. Higher Sway Index values indicate greater postural sway and poorer postural stability.

Sway Index will be assessed during the eyes-open condition on a foam surface using the Modified Clinical Test of Sensory Interaction on Balance (M-CTSIB) performed on the Biodex Balance System. Higher Sway Index values indicate greater postural sway and poorer postural stability.

Sway Index will be assessed during the eyes-closed condition on a foam surface using the Modified Clinical Test of Sensory Interaction on Balance (M-CTSIB) performed on the Biodex Balance System. Higher Sway Index values indicate greater postural sway and poorer postural stability.

Overall Stability Index will be assessed using the Postural Stability Test performed on the Biodex Balance System. Higher values indicate greater postural sway and poorer postural stability.

Anterior/Posterior Stability Index will be assessed using the Postural Stability Test performed on the Biodex Balance System. Higher values indicate greater anterior-posterior postural sway and poorer postural stability.

Medial/Lateral Stability Index will be assessed using the Postural Stability Test performed on the Biodex Balance System. Higher values indicate greater medial-lateral postural sway and poorer postural stability.