دورية أكاديمية
Quality of life improves after thoracoscopic surgical ablation of advanced atrial fibrillation: Results of the Atrial Fibrillation Ablation and Autonomic Modulation via Thoracoscopic Surgery (AFACT) study.
| العنوان: | Quality of life improves after thoracoscopic surgical ablation of advanced atrial fibrillation: Results of the Atrial Fibrillation Ablation and Autonomic Modulation via Thoracoscopic Surgery (AFACT) study. |
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| المؤلفون: | Driessen AHG; Department of Cardiothoracic Surgery, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands., Berger WR; Department of Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands., Bierhuizen MFA; Department of Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands., Piersma FR; Department of Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands., van den Berg NWE; Department of Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands., Neefs J; Department of Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands., Krul SPJ; Department of Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands., van Boven WP; Department of Cardiothoracic Surgery, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands., de Groot JR; Department of Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: j.r.degroot@amc.uva.nl. |
| المصدر: | The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2018 Mar; Vol. 155 (3), pp. 972-980. Date of Electronic Publication: 2017 Sep 27. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial; Video-Audio Media |
| اللغة: | English |
| بيانات الدورية: | Publisher: Mosby Country of Publication: United States NLM ID: 0376343 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-685X (Electronic) Linking ISSN: 00225223 NLM ISO Abbreviation: J Thorac Cardiovasc Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: St. Louis, MO : Mosby Original Publication: St. Louis. |
| مواضيع طبية MeSH: | Quality of Life*, Atrial Fibrillation/*surgery , Autonomic Denervation/*methods , Catheter Ablation/*methods , Ganglia, Autonomic/*surgery , Pulmonary Veins/*surgery , Thoracoscopy/*methods, Adult ; Aged ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/physiopathology ; Autonomic Denervation/adverse effects ; Catheter Ablation/adverse effects ; Electrocardiography ; Female ; Heart Rate ; Humans ; Male ; Middle Aged ; Netherlands ; Pulmonary Veins/physiopathology ; Recurrence ; Surveys and Questionnaires ; Thoracoscopy/adverse effects ; Time Factors ; Treatment Outcome |
| مستخلص: | Objective: We evaluated health-related quality of life at 12 months after thoracoscopic surgical ablation in patients enrolled in the Atrial Fibrillation Ablation and Autonomic Modulation via Thoracoscopic Surgery study. The Atrial Fibrillation Ablation and Autonomic Modulation via Thoracoscopic Surgery study assessed the efficacy and safety of ganglion plexus ablation in patients with symptomatic advanced atrial fibrillation undergoing thoracoscopic surgical ablation. Methods: Patients (n = 240) underwent thoracoscopic pulmonary vein isolation with additional ablation lines in patients with persistent atrial fibrillation. Subjects were randomized to additional ganglion plexus ablation or control. Short Form 36 quality of life questionnaires were collected at baseline and at 6 and 12 months of follow-up. Results: A total of 201 patients were eligible for quality of life analysis (age 59 ± 8 years, 72% were men, 68% had an enlarged left atrium, 57% had persistent atrial fibrillation). Patients improved in physical and mental health at 6 months (both P < .01) and 12 months (both P < .01) relative to baseline, with no difference between the ganglion plexus (n = 101) and control (n = 100) groups. Short Form 36 subscores in patients with 1 or no atrial fibrillation recurrences were similar to those in the general Dutch population after 12 months. Patients with multiple atrial fibrillation recurrences (30%) improved in mental (P < .01), but not physical health, and 6 of 8 Short Form 36 subscales remained below those of the general Dutch population. Patients with irreversible, but not with reversible procedural complications had persistently diminished quality of life scores at 12 months. Conclusions: Thoracoscopic surgery for advanced atrial fibrillation results in improvement in quality of life, regardless of additional ganglion plexus ablation. Quality of life in patients with no or 1 atrial fibrillation recurrence increased to the level of the general Dutch population, whereas in patients with multiple atrial fibrillation recurrences quality of life remained lower. Irreversible but not reversible procedural complications were associated with persistently lower quality of life. (Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.) |
| التعليقات: | Comment in: J Thorac Cardiovasc Surg. 2018 Mar;155(3):970-971. (PMID: 29103819) Comment in: J Thorac Cardiovasc Surg. 2018 Mar;155(3):981-982. (PMID: 29198805) |
| فهرسة مساهمة: | Keywords: atrial fibrillation; ganglion plexus ablation; health-related quality of life; thoracoscopic surgery |
| تواريخ الأحداث: | Date Created: 20171102 Date Completed: 20190924 Latest Revision: 20190925 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.jtcvs.2017.09.093 |
| PMID: | 29089093 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1097-685X |
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| DOI: | 10.1016/j.jtcvs.2017.09.093 |