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心房颤动导管消融术后吸气肌训练:一项初步研究。

Inspiratory muscle training after atrial fibrillation catheter ablation: A pilot study.

作者信息

Oguri Gaku, Amiya Eisuke, Fujiu Katsuhito, Taya Masanobu, Oshima Tsukasa, Shimizu Yu, Yamagata Kenichiro, Hasumi Eriko, Kojima Toshiya, Takeda Norihiko

机构信息

Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Department of Advanced Cardiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

出版信息

Medicine (Baltimore). 2025 Jul 4;104(27):e43181. doi: 10.1097/MD.0000000000043181.

Abstract

Atrial fibrillation management is challenging, and traditional cardiac rehabilitation often overlooks respiratory issues. We aimed to evaluate the safety and efficacy of cardiac rehabilitation with inspiratory muscle training to enhance respiratory and cardiac functions after atrial fibrillation catheter ablation. This prospective, single-center observational study, conducted at the University of Tokyo Hospital between February 2019 and January 2020, included 5 men (average age 68.4 ± 2.58 years) who underwent initial ablation for symptomatic paroxysmal (n = 1) or non-paroxysmal (n = 4) atrial fibrillation. The participants underwent inspiratory muscle training alongside standard cardiac rehabilitation (intensity: 20% of the maximal inspiratory pressure, adjusted weekly). The pre- and post-intervention ejection fraction, left atrial volume index, and brain natriuretic peptide levels were evaluated. Inspiratory muscle training integration was associated with improvements in respiratory muscle strength and pulmonary function. The average ejection fraction improved from 62.0% to 64.4%, the left atrial volume index decreased from 39.4 mL/m2 to 27.0 mL/m2, and brain natriuretic peptide levels reduced from 112.28 pg/mL to 20.98 pg/mL. The anaerobic threshold increased from a mean of 12.3 to 14.2, and the mean peak oxygen uptake increased from 16.72 mL/kg/min to 18.12 mL/kg/min. Over a 4-year follow-up, atrial fibrillation recurrence was observed in only 1 of the 5 patients. Inspiratory muscle training, when integrated with cardiac rehabilitation, could potentially improve respiratory and cardiac function in patients with post-atrial fibrillation ablation and may help reduce the likelihood of atrial fibrillation recurrence. This pilot study supports the potential of inspiratory muscle training in enhancing standard rehabilitation protocols, warranting further investigation in larger randomized trials to substantiate these findings and explore long-term benefits.

摘要

心房颤动的管理具有挑战性,传统的心脏康复通常会忽视呼吸问题。我们旨在评估在心房颤动导管消融术后进行吸气肌训练的心脏康复对增强呼吸和心脏功能的安全性和有效性。这项前瞻性、单中心观察性研究于2019年2月至2020年1月在东京大学医院进行,纳入了5名男性(平均年龄68.4±2.58岁),他们因症状性阵发性(n = 1)或非阵发性(n = 4)心房颤动接受了初次消融。参与者在标准心脏康复的同时进行吸气肌训练(强度:最大吸气压力的20%,每周调整)。评估了干预前后的射血分数、左心房容积指数和脑钠肽水平。吸气肌训练的整合与呼吸肌力量和肺功能的改善相关。平均射血分数从62.0%提高到64.4%,左心房容积指数从39.4 mL/m²降至27.0 mL/m²,脑钠肽水平从112.28 pg/mL降至20.98 pg/mL。无氧阈值从平均12.3提高到14.2,平均峰值摄氧量从16.72 mL/kg/min增加到18.12 mL/kg/min。在4年的随访中,5名患者中仅1例观察到心房颤动复发。吸气肌训练与心脏康复相结合,可能会改善心房颤动消融术后患者的呼吸和心脏功能,并可能有助于降低心房颤动复发的可能性。这项初步研究支持了吸气肌训练在增强标准康复方案方面的潜力,有必要在更大规模的随机试验中进一步研究以证实这些发现并探索长期益处。

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