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患者对心房颤动导管消融术后当日出院的看法:来自单中心 FAST AFA 试验中患者调查的结果。

Patient perspectives on same-day discharge following catheter ablation for atrial fibrillation: results from a patient survey as part of the monocentric FAST AFA trial.

机构信息

Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Strümpellstraße 39, 04289 Leipzig, Germany.

Real World Evidence & Health Technology Assessment, Helios Health Institute, Berlin, Germany.

出版信息

Europace. 2023 Aug 2;25(9). doi: 10.1093/europace/euad262.

DOI:10.1093/europace/euad262
PMID:37656979
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10492224/
Abstract

AIMS

Same-day discharge (SDD) following catheter ablation (CA) of atrial fibrillation (AF) was already introduced in selected facilities in Europe, but a widespread implementation has not yet succeeded. Data on patients' perspectives are lacking. Therefore, we conducted a survey to address patients' beliefs towards SDD and identify variables that are associated with their evaluation.

METHODS AND RESULTS

As part of the prospective, monocentric FAST AFA trial, patients aged ≥20 years undergoing left atrial CA for AF were asked to participate in the survey consisting of a study-specific questionnaire, the AF knowledge scale, and pre-defined patient-reported outcome measures. The study cohort was stratified based on SDD willingness, and a logistic regression analysis was used to identify predictors for patients' valuation. Between 26 July 2021 and 01 July 2022, 256 of 376 screened patients consented to study participation of whom 248 (mean age 61.8 years, 33.9% female) completed the SDD survey. Of them, 50.0% were willing to have SDD concepts integrated into their clinical course with increased patient comfort (27.5%), shorter waiting times (14.6%), and a cost-efficient treatment (14.0%) being imaginable benefits. In contrast, expressed concerns included uncertainties with occurring complaints (50.6%), the insufficient recognition (47.8%), and treatment (48.9%) of complications. European Heart Rhythm Association class at baseline and inpatient treatments within the preceding year were predictors for SDD willingness whereas comorbidity burden or AF knowledge were not.

CONCLUSION

We provide a detailed survey expressing patients' beliefs towards SDD following left atrial CA. Our findings may facilitate adequate patient selection to improve the future implementation of SDD programs in suitable cohorts.

摘要

目的

欧洲部分机构已将房颤(AF)导管消融(CA)后的当日出院(SDD)引入临床,但尚未广泛实施。目前缺乏患者观点的数据。因此,我们进行了一项调查,以了解患者对 SDD 的看法,并确定与他们评估相关的变量。

方法和结果

作为前瞻性、单中心 FAST AFA 试验的一部分,我们邀请年龄≥20 岁、因 AF 行左心房 CA 的患者参与调查,调查内容包括特定于研究的问卷、房颤知识量表和预定义的患者报告结局指标。根据 SDD 意愿对研究队列进行分层,并使用逻辑回归分析确定患者评估的预测因素。在 2021 年 7 月 26 日至 2022 年 7 月 1 日期间,对 376 名筛选出的患者进行了调查,其中 256 名(平均年龄 61.8 岁,33.9%为女性)患者完成了 SDD 调查。其中,50.0%的患者愿意接受 SDD 概念,认为这将增加患者舒适度(27.5%)、缩短等待时间(14.6%)和提高治疗的成本效益(14.0%)。相比之下,患者表达的担忧包括对出现的并发症的不确定性(50.6%)、对并发症的认识不足(47.8%)和治疗不足(48.9%)。基线时的欧洲心脏病学会心律失常协会(EHRA)分级和前一年的住院治疗是 SDD 意愿的预测因素,而合并症负担或房颤知识则不是。

结论

我们提供了一份详细的调查,表达了患者对左心房 CA 后 SDD 的看法。我们的发现可能有助于适当选择患者,以改善未来在合适患者人群中实施 SDD 方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c70/10492224/2c8b2d003795/euad262_ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c70/10492224/2c8b2d003795/euad262_ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c70/10492224/2c8b2d003795/euad262_ga1.jpg

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本文引用的文献

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Same-day discharge for atrial fibrillation ablation: outcomes and impact of ablation modality.房颤消融术的当日出院:消融方式的结果和影响。
Europace. 2023 Feb 16;25(2):400-407. doi: 10.1093/europace/euac170.
2
Efficacy and safety of same-day discharge after atrial fibrillation ablation compared with post-procedural overnight stay: a systematic review and meta-analysis.房颤消融术后即日出院与术后过夜留观的疗效和安全性比较:系统评价和荟萃分析。
Europace. 2022 Oct 13;24(10):1569-1584. doi: 10.1093/europace/euac068.
3
Safety and feasibility of same-day discharge following catheter ablation of atrial fibrillation: what is known and what needs to be explored?
当日出院与房颤导管消融术后过夜住院的比较:欧洲心律协会卫生经济委员会的全面综述和荟萃分析。
Europace. 2024 Aug 3;26(8). doi: 10.1093/europace/euae200.
房颤导管消融术后即日出院的安全性和可行性:已知和需要探索的内容?
Herz. 2022 Apr;47(2):123-128. doi: 10.1007/s00059-022-05102-0. Epub 2022 Mar 7.
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Safety and feasibility of same-day discharge for catheter ablation of atrial fibrillation: a systematic review and meta-analysis.心房颤动导管消融当日出院的安全性与可行性:一项系统评价与荟萃分析
J Interv Card Electrophysiol. 2022 Dec;65(3):803-811. doi: 10.1007/s10840-022-01145-9. Epub 2022 Feb 11.
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Administrative data confirm safety of same-day discharge following catheter ablation of atrial fibrillation: all good or is there a fly in the ointment?行政数据证实房颤导管消融术后当日出院的安全性:一切皆好还是美中不足?
Europace. 2022 May 3;24(5):701-702. doi: 10.1093/europace/euac009.
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7
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