A comparison of the real world effectiveness of catheter ablation and drug therapy in atrial fibrillation patients in a Chinese settingReport as inadecuate




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BMC Cardiovascular Disorders

, 17:204

Non-coronary artery cardiac disease

Abstract

BackgroundStudies have demonstrated that catheter ablation of atrial fibrillation is associated with better rhythm control than drug therapy. The present study aimed to assess the clinical outcomes and health-related quality of life of ablation therapy in a real world setting.

MethodsA prospective, non-randomized, single center study in a real-world clinical setting in China was conducted. Patients were followed up at 3, 6, and 9 months after baseline encounter. Propensity score matched patients receiving ablation or anti-arrhythmic drug therapy were compared. Incidence rate of atrial fibrillation recurrence and quality of life outcomes were measured and analyzed using log-rank test, multivariate logistic regression and mixed-effects linear regression respectively.

ResultsIn this study, 151 atrial fibrillation patients treated by ablation therapy and 318 patients treated by anti-arrhythmic drugs were enrolled. During follow up, 82.0% in the ablation arm and 22.4% in the drug arm had no documented atrial fibrillation recurrence HR for atrial fibrillation recurrence 0.07 95%CI: 0.02–0.21, p < 0.0001 among paroxysmal atrial fibrillation patients. The corresponding no recurrent rate were 66.7% and 18.5% 0.21 0.05–0.95, p = 0.04 respectively among persistent atrial fibrillation patients. Improvement in Short Form-36 physical component scores, Short Form-36 mental component scores and total Atrial Fibrillation Effect on Quality-of-life scores were 16.33 14.05–18.61, p < 0.001, 8.10 6.11–10.09, p < 0.001 and 18.28 16.11–20.45, p < 0.001 respectively among paroxysmal AF patients and 6.32 3.15–9.49, p < 0.001, 3.99 1.82–6.16, p < 0.001 and 13.97 10.89–17.05, p < 0.001 respectively among persistent AF patients. Improvements in total Atrial Fibrillation Effect on Quality-of-life score were also significant in ablation arm while no significant improvement of total Atrial Fibrillation Effect on Quality-of-life score in the drug arm.

ConclusionCompared with drug therapy, catheter ablation is associated with significant lower AF recurrence and improved overall quality of life.

Trial registrationThe present study has been registered on clinicaltrials.gov. The ClinicalTrials.gov ID is NCT01878981. The registration date is May 29, 2013.

KeywordsCatheter ablation Atrial fibrillation Anti-arrhythmic drugs Quality of life Chinese AbbreviationsAADsAntiarrhythmic drugs

AFAtrial fibrillation

AFEQTAtrial Fibrillation Effect on Quality-of-life

MCSSF-36 Mental Component Summary

PCSSF-36 Physical Component Summary

PVPulmonary vein

QoLQuality of life

SF-36Short Form-36

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Author: Xin Du - Lizhu Guo - Xiaonan He - Yu Jia - Jiahui Wu - Deyong Long - Ronghui Yu - Caihua Sang - Xiaohui Liu - Hongjun Yi

Source: https://link.springer.com/







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