Victoria Svedung Wettervik, Jonas Schwieler, Lennart Bergfeldt, Göran Kennebäck, Steen Jensen, Aigars Rubulis, Elena Sciaraffia, Carina Blomström-Lundqvist
{"title":"导管消融术与抗心律失常药物治疗心房颤动患者的长期健康相关生活质量和心律失常结果。","authors":"Victoria Svedung Wettervik, Jonas Schwieler, Lennart Bergfeldt, Göran Kennebäck, Steen Jensen, Aigars Rubulis, Elena Sciaraffia, Carina Blomström-Lundqvist","doi":"10.1016/j.hrthm.2024.09.044","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Data on long-term effects of catheter ablation versus antiarrhythmic drugs (AAD) on health-related quality of life (HRQoL) and atrial fibrillation (AF) burden are limited.</p><p><strong>Objective: </strong>The study aimed to assess long-term HRQoL and rhythm data in symptomatic AF patients.</p><p><strong>Methods: </strong>The 75 patients who underwent ablation and 74 receiving AAD in the Catheter Ablation compared with Pharmacological Therapy for Atrial Fibrillation (CAPTAF) trial were followed for 48 months. General Health using 36-Item Short-Form Health Survey, time to first AF-episode ≥1 hour, and AF burden, recorded by implantable cardiac monitors, were compared.</p><p><strong>Results: </strong>147 patients completed follow-up, with seven crossovers in the ablation group and 34 crossovers in the AAD group. General Health improved by ablation, median 62 points at baseline to 79.2 points at follow-up (p<0.001), and by AAD from median 67 to 77 points (p<0.001), without treatment differences (p=0.77). Time to first AF-episode ≥1 hour was longer, median 257 days (ablation group) versus 180 days (AAD group), p=0.025. The cumulative AF burden during follow-up was lower in the ablation (median 0.3% [interquartile range 0, 1.4]) versus the AAD group (1.6% [0.1, 11.0]), p=0.01. The cumulative reduction in AF burden compared with baseline was greater in the ablation (median -89.5% [-98.4, -51.3]) versus the AAD group (-52.7% [-92.6, 263.6]), p<0.001).</p><p><strong>Conclusions: </strong>HRQoL improvement at long-term did not differ between ablation and AAD group despite a larger reduction in AF burden after ablation. The results should be interpreted in the light of a high crossover rate in the AAD group.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6000,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-term Health-related Quality of Life and Rhythm-Outcomes of Catheter Ablation versus Antiarrhythmic Drugs in Patients with Atrial Fibrillation.\",\"authors\":\"Victoria Svedung Wettervik, Jonas Schwieler, Lennart Bergfeldt, Göran Kennebäck, Steen Jensen, Aigars Rubulis, Elena Sciaraffia, Carina Blomström-Lundqvist\",\"doi\":\"10.1016/j.hrthm.2024.09.044\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Data on long-term effects of catheter ablation versus antiarrhythmic drugs (AAD) on health-related quality of life (HRQoL) and atrial fibrillation (AF) burden are limited.</p><p><strong>Objective: </strong>The study aimed to assess long-term HRQoL and rhythm data in symptomatic AF patients.</p><p><strong>Methods: </strong>The 75 patients who underwent ablation and 74 receiving AAD in the Catheter Ablation compared with Pharmacological Therapy for Atrial Fibrillation (CAPTAF) trial were followed for 48 months. General Health using 36-Item Short-Form Health Survey, time to first AF-episode ≥1 hour, and AF burden, recorded by implantable cardiac monitors, were compared.</p><p><strong>Results: </strong>147 patients completed follow-up, with seven crossovers in the ablation group and 34 crossovers in the AAD group. General Health improved by ablation, median 62 points at baseline to 79.2 points at follow-up (p<0.001), and by AAD from median 67 to 77 points (p<0.001), without treatment differences (p=0.77). Time to first AF-episode ≥1 hour was longer, median 257 days (ablation group) versus 180 days (AAD group), p=0.025. The cumulative AF burden during follow-up was lower in the ablation (median 0.3% [interquartile range 0, 1.4]) versus the AAD group (1.6% [0.1, 11.0]), p=0.01. The cumulative reduction in AF burden compared with baseline was greater in the ablation (median -89.5% [-98.4, -51.3]) versus the AAD group (-52.7% [-92.6, 263.6]), p<0.001).</p><p><strong>Conclusions: </strong>HRQoL improvement at long-term did not differ between ablation and AAD group despite a larger reduction in AF burden after ablation. The results should be interpreted in the light of a high crossover rate in the AAD group.</p>\",\"PeriodicalId\":12886,\"journal\":{\"name\":\"Heart rhythm\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":5.6000,\"publicationDate\":\"2024-09-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart rhythm\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.hrthm.2024.09.044\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart rhythm","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hrthm.2024.09.044","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Long-term Health-related Quality of Life and Rhythm-Outcomes of Catheter Ablation versus Antiarrhythmic Drugs in Patients with Atrial Fibrillation.
Background: Data on long-term effects of catheter ablation versus antiarrhythmic drugs (AAD) on health-related quality of life (HRQoL) and atrial fibrillation (AF) burden are limited.
Objective: The study aimed to assess long-term HRQoL and rhythm data in symptomatic AF patients.
Methods: The 75 patients who underwent ablation and 74 receiving AAD in the Catheter Ablation compared with Pharmacological Therapy for Atrial Fibrillation (CAPTAF) trial were followed for 48 months. General Health using 36-Item Short-Form Health Survey, time to first AF-episode ≥1 hour, and AF burden, recorded by implantable cardiac monitors, were compared.
Results: 147 patients completed follow-up, with seven crossovers in the ablation group and 34 crossovers in the AAD group. General Health improved by ablation, median 62 points at baseline to 79.2 points at follow-up (p<0.001), and by AAD from median 67 to 77 points (p<0.001), without treatment differences (p=0.77). Time to first AF-episode ≥1 hour was longer, median 257 days (ablation group) versus 180 days (AAD group), p=0.025. The cumulative AF burden during follow-up was lower in the ablation (median 0.3% [interquartile range 0, 1.4]) versus the AAD group (1.6% [0.1, 11.0]), p=0.01. The cumulative reduction in AF burden compared with baseline was greater in the ablation (median -89.5% [-98.4, -51.3]) versus the AAD group (-52.7% [-92.6, 263.6]), p<0.001).
Conclusions: HRQoL improvement at long-term did not differ between ablation and AAD group despite a larger reduction in AF burden after ablation. The results should be interpreted in the light of a high crossover rate in the AAD group.
期刊介绍:
HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability.
HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community.
The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.