دورية أكاديمية
أعرض في EDS

Outcome of tailored therapy in rheumatic heart disease with persistent atrial fibrillation (RHD-AF).

التفاصيل البيبلوغرافية
العنوان: Outcome of tailored therapy in rheumatic heart disease with persistent atrial fibrillation (RHD-AF).
المؤلفون: Saggu DK; Department of Cardiology, AIG Hospital, Hyderabad, India., Subramaniam M; Department of Cardiology, AIG Hospital, Hyderabad, India., Korabathina R; Department of Cardiology, AIG Hospital, Hyderabad, India., Raju BS; Department of Cardiology, AIG Hospital, Hyderabad, India., Atreya AR; Department of Cardiology, AIG Hospital, Hyderabad, India., Reddy P; Department of Cardiology, AIG Hospital, Hyderabad, India., Kumar DN; Department of Cardiology, AIG Hospital, Hyderabad, India., Menon R; Department of Cardiology, AIG Hospital, Hyderabad, India., Yalagudri S; Department of Cardiology, AIG Hospital, Hyderabad, India., Kapadiya A; Department of Cardiology, AIG Hospital, Hyderabad, India., Chennapragada S; Department of Cardiology, AIG Hospital, Hyderabad, India., Narasimhan C; Department of Cardiology, AIG Hospital, Hyderabad, India.
المصدر: Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2024 Aug; Vol. 47 (8), pp. 1096-1107. Date of Electronic Publication: 2024 Jul 04.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Futura Pub. Co. Country of Publication: United States NLM ID: 7803944 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8159 (Electronic) Linking ISSN: 01478389 NLM ISO Abbreviation: Pacing Clin Electrophysiol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Mount Kisco, N. Y. : Futura Pub. Co., c1978-
مواضيع طبية MeSH: Atrial Fibrillation*/therapy , Atrial Fibrillation*/physiopathology , Rheumatic Heart Disease*/therapy , Rheumatic Heart Disease*/complications, Humans ; Female ; Male ; Middle Aged ; Electric Countershock ; Catheter Ablation/methods ; Anti-Arrhythmia Agents/therapeutic use
مستخلص: Introduction: Rheumatic heart disease with persistent atrial fibrillation (RHD-AF) is associated with increased morbidity. However, there is no standardized approach for the maintenance of sinus rhythm (SR) in them. We aimed to determine the utility of a stepwise approach to achieve SR in RHD-AF.
Methods: Consecutive patients with RHD-AF from July 2021 to August 2023 formed the study cohort. The stepwise approach included pharmacological rhythm control and/or electrical cardioversion (Central illustration). In patients with recurrence, additional options included AF ablation or pace and ablate strategy with conduction system pacing or biventricular pacing. Clinical improvement, NT-proBNP, 6-Minute Walk Test (6MWT), heart failure (HF) hospitalizations, and thromboembolic complications were documented during follow-up.
Results: Eighty-three patients with RHD-AF (mean age 56.13 ± 9.51 years, women 72.28%) were included. Utilizing this approach, 43 (51.81%) achieved and maintained SR during the study period of 11.04 ± 7.14 months. These patients had improved functional class, lower NT-proBNP, better distance covered for 6MWT, and reduced HF hospitalizations. The duration of AF was shorter in patients who achieved SR, compared to those who remained in AF (3.15 ± 1.29 vs 6.93 ± 5.23, p = 0.041). Thirty-five percent (29) maintained SR after a single cardioversion over the study period. Only one underwent AF ablation. Of the 24 who underwent pace and ablate strategy, atrial lead was implanted in 22 (hybrid approach), and 50% of these achieved and maintained SR. Among these 24, none had HF hospitalizations, but patients who maintained SR had further improvement in clinical and functional parameters.
Conclusions: RHD-AF patients who could achieve SR with a stepwise approach, had better clinical outcomes and lower HF hospitalizations.
(© 2024 Wiley Periodicals LLC.)
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معلومات مُعتمدة: Granules India (AIG Hospital, Institutional grant); the Indian Heart Rhythm Society (IHRS)
فهرسة مساهمة: Keywords: conduction system pacing; oral anticoagulation; pace and ablate; persistent atrial fibrillation; rate control; rheumatic atrial fibrillation; rheumatic heart disease; rhythm control; valvular atrial fibrillation; vitamin K antagonist
المشرفين على المادة: 0 (Anti-Arrhythmia Agents)
تواريخ الأحداث: Date Created: 20240704 Date Completed: 20240806 Latest Revision: 20240806
رمز التحديث: 20240806
DOI: 10.1111/pace.15041
PMID: 38963723
قاعدة البيانات: MEDLINE
الوصف
تدمد:1540-8159
DOI:10.1111/pace.15041