Rigshospitalet, The Heart Centre, Copenhagen University Hospital, Denmark & Copenhagen University College, Copenhagen, Denmark (Drs Risom, Zwisler, Svendsen, and Berg); National Institute of Public Health, University of Southern, Odense, Denmark (Drs Zwisler, Svendsen, and Berg); Centre for Rehabilitation and Palliation, University of Southern Denmark and University Hospital Odense, Odense, Denmark (Dr Zwisler); National Institute of Public Health, University of Southern Denmark, Odense, Denmark (Drs Thygesen and Berg); Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Dr Berg); and The Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark (Dr Svendsen).
J Cardiopulm Rehabil Prev. 2019 Jan;39(1):33-38. doi: 10.1097/HCR.0000000000000395.
Today, catheter ablation is a widely used treatment for atrial fibrillation (AF) and atrial flutter (AFL). Knowledge on long-term patient-reported outcomes and readmissions is lacking and is warranted to plan optimal follow-up care. Objectives were to describe patient-reported outcomes including perceived health, quality of life, anxiety, depression, and physical activity compared with an age- and sex-matched reference population without longstanding disease; readmissions and mortality; and factors associated with suboptimal patient-reported outcomes.
A nationwide cross-sectional survey mailed to 627 adults 6 to 12 mo after ablation for AF or AFL including; Short Form-36 (SF-36), HeartQoL, Hospital Anxiety Depression Scale, and questions about physical activity. Readmission rates and mortality were obtained and regression analyses were performed.
Comparing the patient group (response rate: 74%, n = 462) with an age- and sex-matched reference population with no long-lasting disease, differences were found in all subscales of SF-36 and leisure-time physical activity in favor of the reference group (P < .001). Within 1 yr, 411 patients (59%) were readmitted and the total number of readmissions was 1167. Altogether, 227 (33%) patients were electively readmitted and 330 (48%) were acutely readmitted. Ten patients (1.4%) died. Age > 59 yr, female sex, high comorbidity, and readmission were associated with low physical health, low perceived health, and low quality of life.
Patients treated for AF or AFL experienced decreased mental and physical health and high readmission rates 6 to 12 mo following catheter ablation. Closer multidisciplinary follow-up or cardiac rehabilitation after ablation for AF or AFL may be needed.
如今,导管消融术已被广泛用于治疗心房颤动(AF)和心房扑动(AFL)。缺乏关于长期患者报告结局和再入院的知识,有必要计划最佳的随访护理。目的是描述患者报告的结局,包括与无长期疾病的年龄和性别匹配的参考人群相比,感知健康、生活质量、焦虑、抑郁和体力活动;再入院率和死亡率;以及与患者报告结局不理想相关的因素。
一项全国性的横断面调查,通过邮件发送给 627 名在 AF 或 AFL 消融术后 6 至 12 个月的成年人,包括:SF-36 简短量表、心脏生活质量问卷、医院焦虑抑郁量表以及关于体力活动的问题。获得再入院率和死亡率,并进行回归分析。
与无长期疾病的年龄和性别匹配的参考人群相比,患者组(应答率:74%,n=462)在 SF-36 的所有子量表和休闲时间体力活动方面存在差异,均有利于参考组(P<0.001)。在 1 年内,有 411 名患者(59%)再次入院,总再入院人数为 1167 人。总共,有 227 名(33%)患者为择期再入院,330 名(48%)为急性再入院。有 10 名患者(1.4%)死亡。年龄>59 岁、女性、高合并症和再入院与较低的生理健康、较差的健康感知和较低的生活质量相关。
接受 AF 或 AFL 治疗的患者在导管消融术后 6 至 12 个月经历了心理健康和身体健康的下降,并且再入院率较高。AF 或 AFL 消融后可能需要更密切的多学科随访或心脏康复。