Barriers and Facilitators to the Initiation of Home-Based Exercise Rehabilitation After Radiofrequency Catheter Ablation for Atrial Fibrillation: A TDF-Based Qualitative Study.

Abstract

Purpose Home-based exercise rehabilitation is important for recovery after atrial fibrillation (AF) ablation. However, the barriers and facilitators influencing the initiation of home-based exercise rehabilitation during the early post-ablation recovery phase remain insufficiently understood. This study aimed to explore the barriers and facilitators influencing the initiation of home-based exercise rehabilitation among patients following radiofrequency catheter ablation for AF, guided by the Theoretical Domains Framework (TDF). Patients and methods A descriptive qualitative study was conducted using purposive sampling. Twenty patients who had undergone radiofrequency catheter ablation for AF were recruited from a tertiary general hospital in Jiangsu Province, China. Formal data collection was conducted from August to December 2025.Face-to-face semi-structured interviews were conducted individually during routine follow-up approximately one month after ablation. The phenomenon under investigation was the initiation of home-based exercise rehabilitation during the early recovery phase, referring to patients' transition toward intentional, planned exercise activities performed at home after discharge and recommended or guided by healthcare professionals. Data were analysed using qualitative content analysis with a hybrid inductive-deductive approach informed by the TDF. Results Factors influencing the initiation of home-based exercise rehabilitation were categorized into promoting and impeding factors. A total of 11 influencing factors were identified: 3 promoting factors (benefit-driven motivation, trust and recognition of professionals, and family responsibility as a motivator) and 8 impeding factors (lack of exercise knowledge, inadequate skill mastery, low exercise self-efficacy, distress from physical symptoms, poor resource accessibility, negative emotional distress, and absence of exercise plans). Conclusion The initiation of home-based exercise rehabilitation after radiofrequency catheter ablation for AF is influenced by multiple interacting individual, professional, and contextual factors. Support strategies should address patients' knowledge and skills, confidence, symptom-related concerns, access to professional guidance and rehabilitation resources, and competing social responsibilities to facilitate the initiation of home-based exercise rehabilitation during early recovery.