PREACTIVE: Preconditioning Exercise Intervention to Improve Symptoms and Quality of Life in Comorbid Atrial Fibrillation and HFpEF

Exclusion Criteria

• •Valvular heart disease as the primary etiology of heart failure (i.e., severe aortic stenosis or mitral regurgitation),
• •New York Heart Association Stage IV
• •Recent stroke (\<1 year)
• •Evidence or History of Cardiac amyloidosis
• •Patients with persistent AF and poor rate control (HR \> 110 at rest)
• •Significant change in cardiac medication or Heart Failure symptoms \< 2 weeks
• •Unstable or severe angina not controlled during daily activity by pharmacological therapy or at \<4 METS activity
• •Uncontrolled hypertension (defined as systolic blood pressure \>200 mm Hg and/or diastolic blood pressure\>110 mm Hg) with medications
• •Uncontrolled diabetes with recent weight loss, diabetic coma, or frequent insulin reactions
• •Hospitalization or urgent care visit \< 4 weeks
• •Oxygen dependent Chronic Obstructive Pulmonary Disease (COPD)
• •Significant anemia (\<10 g/dL Hgb)
• •End stage renal replacement therapy associated with the need for dialysis
• •Active treatment for cancer defined as current radiation, chemotherapy, immunotherapy, or cancer recurrence within past 5 years
• •Hospice care and indication of life expectancy less than 2 years
• •Complete dependence confinement to a Wheelchair confinement or requiring a visual impairment or Orthopedic or severe musculoskeletal conditions that would prohibit resistance training or aerobic exercise.
• •Physician diagnosed Alzheimer's disease or Dementia or bipolar or psychotic disorder; Montreal Cognitive Assessment (MoCA) is ≤ 18 (based on participant screening)
• •High levels of physical functioning based the composite short physical performance battery score of ≥10 (out of 12)
• •Planned major surgery, coronary or leg revascularization during the next six months
• •Participation in a supervised exercise program or already engaging in regular exercise
• •Plans to transfer care outside of NU within the study period
• •Unable to consent or commit to requires study procedures
• •Non-English speaking