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Cardiac Rehabilitation for Patients Treated for Atrial Fibrillation With Ablation Has Long-Term Effects: 12-and 24-Month Follow-up Results From the Randomized CopenHeartRFA Trial

Published:August 01, 2020DOI:https://doi.org/10.1016/j.apmr.2020.06.026

      Abstract

      Objective

      To assess outcomes at 12 and 24 months after participation in a multidisciplinary cardiac rehabilitation program plus usual care compared with usual care alone for patients treated for atrial fibrillation with catheter ablation.

      Design

      Long-term follow-up on the randomized CopenHeartRFA trial.

      Setting

      Patients were enrolled and outcome assessed at the hospital and the intervention were carried out at the hospital or at local rehabilitation centers.

      Participants

      Patients (N=210) treated for atrial fibrillation with catheter ablation included in the CopenHeartRFA trial.

      Interventions

      A 6-month cardiac rehabilitation program consisting of physical exercise and psychoeducational consultations plus usual care or usual care alone.

      Main Outcome Measures

      Physical capacity was measured by peak oxygen uptake (Vo2peak) at 12 months, and patient-reported outcomes on perceived health, anxiety, and depression were collected by validated questionnaires at 12 and 24 months. Information on hospital admissions and mortality was collected through national registers up to 24 months.

      Results

      Mean Vo2peak was higher at 12 months in the cardiac rehabilitation group (cardiac rehabilitation group: 25.82 mL/kg/min vs usual care group, 22.43 mL/kg/min, P=.003). A lower proportion of patients had high levels of anxiety at 24 months in the cardiac rehabilitation group compared to usual care (12% vs 24%, P=.004). There was no difference in mortality or hospital admissions at 24 months between groups.

      Conclusions

      This long-term follow-up of a comprehensive multidisciplinary cardiac rehabilitation program for patients treated for atrial fibrillation with catheter ablation found sustained improvements with respect to physical capacity and anxiety compared to usual care but no difference on mortality or hospital admission.

      Keywords

      List of abbreviations:

      AF (atrial fibrillation), AFEQT (Atrial Fibrillation Effect on QualiTy of life), CPET (cardiopulmonary exercise testing), HADS-A (Hospital Anxiety and Depression Scale Anxiety), HADS-D (Hospital Anxiety and Depression Scale Depression), HRQOL (health-related quality of life), MCS (Mental Component Scale), RFA (radiofrequency catheter ablation), SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey), Vo2peak (peak oxygen uptake)
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