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. 2021 Oct;36(10):1542-1550.
doi: 10.1007/s00380-021-01829-8. Epub 2021 Apr 3.

Cardiac rehabilitation after catheter ablation of atrial fibrillation in patients with left ventricular dysfunction

Daisetsu Aoyama  1 , Shinsuke Miyazaki  2 , Kanae Hasegawa  2 , Moeko Nagao  2 , Shota Kakehashi  2 , Moe Mukai  2 , Takayuki Sekihara  2 , Minoru Nodera  2 , Tomoya Eguchi  2 , Takayoshi Aiki  2 , Junya Yamaguchi  2 , Yuichiro Shiomi  2 , Naoto Tama  2 , Hiroyuki Ikeda  2 , Kentaro Ishida  2 , Hiroyasu Uzui  2 , Hiroshi Tada  2
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Cardiac rehabilitation after catheter ablation of atrial fibrillation in patients with left ventricular dysfunction

Daisetsu Aoyama et al. Heart Vessels. 2021 Oct.

Abstract

Few studies have examined the efficacy and safety of cardiac rehabilitation in patients with atrial fibrillation (AF) who underwent AF ablation. We explored the feasibility of additional cardiac rehabilitation after AF ablation in patients with a reduced left ventricular ejection fraction (LVEF). Fifty-four patients with heart failure (HF) and a reduced LVEF (HFrEF) (LVEF < 50%; 67.1 ± 11.6 years; 43 men) who underwent initial AF ablation procedures were included. Fourteen (25.9%) patients underwent cardiac rehabilitation (rehabilitation-group) and the remaining 40 (74.1%) did not (non-rehabilitation-group) after the procedure. The rehabilitation-group patients were relatively older, more likely female (p = 0.024), and had more likely a history of an HF hospitalization (p < 0.01) and cardiac device implantation (p = 0.041). The baseline LVEF was significantly lower (p = 0.043) and brain natriuretic peptide (BNP) (p < 0.01) and C-reactive protein (CRP) (p < 0.01) values were significantly higher in the rehabilitation-group. The 6-min walk distance significantly improved after 21.4 ± 11.5 days of cardiac rehabilitation during hospitalization (226.1 ± 155.9 vs. 398.1 ± 77.5 m, p = 0.016) without any adverse events. During an 18.9 ± 6.3 month follow-up period, the freedom from AF recurrence (p = 0.52) and re-hospitalizations due to HF (p = 0.63) were similar between the 2 groups. No death or strokes were observed. During the follow-up period, the LVEF significantly improved similarly in both groups, and the change in the BNP and CRP values significantly decreased in the rehabilitation-group. Despite the rehabilitation-group patients having a more severe HF status, the clinical outcomes and AF freedom were similar between the 2 groups, suggesting the favorable impact of cardiac rehabilitation after AF ablation in HFrEF patients.

Keywords: Atrial fibrillation; Cardiac rehabilitation; Catheter ablation; Left ventricular dysfunction.

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References

    1. Wilke T, Groth A, Muller S, Pfannkuche M, Verheyen F, Linder R, Maywald U, Bauersachs R, Breithardt G (2013) Incidence and prevalence of atrial fibrillation: an analysis based on 83 million patients. Europace 15(4):486–493 - DOI
    1. Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin EJ, Gillum RF, Kim YH, McAnulty JH Jr, Zheng ZJ, Forouzanfar MF, Naghavi M, Mensah GA, Ezzati M, Murray CJ (2014) Worldside epidemiology of atrial fibrillation: a Grobal Burden of Disease 2010 Study. Circulation 129(8):837–847 - DOI
    1. Steven D, Rostock T, Lutomsky B, Klemm H, Servatius H, Drewitz I, Friedrichs K, Ventura R, Meinertz T, Willems S (2008) What is the real atrial fibrillation burden after catheter ablation of atrial fibrillation? A prospective rhythm analysis in pacemaker patients with continuous atrial monitoring. Eur Heart J 29(8):1037–1042 - DOI
    1. Di Biase L, Mohanty P, Mohanty S, Santangeli P, Trivedi C, Lakkireddy D, Reddy M, Jais P, Themistoclakis S, Dello Russo A, Casella M, Pelargonio G, Narducci ML, Schweikert R, Neuzil P, Sanchez J, Horton R, Beheiry S, Hongo R, Hao S, Rossillo A, Forleo G, Tondo C, Burkhardt JD, Haissaguerre M, Natale A (2016) Ablation versus amiodarone for treatment of persistent atrial fibrillation in patients with congestive heart failure and an implanted device: results from the AATAC multicenter randomized trial. Circulation 133(17):1637–1644 - DOI
    1. Calkins H, Calkins H, Hindricks G, Cappato R, Kim YH, Saad EB, Aguinaga L, Akar JG, Badhwar V, Brugada J, Camm J, Chen PS, Chen SA, Chung MK, Nielsen JC, Curtis AB, Davies DW, Day JD, d’Avila A, de Groot NMSN, Di Biase L, Duytschaever M, Edgerton JR, Ellenbogen KA, Ellinor PT, Ernst S, Fenelon G, Gerstenfeld EP, Haines DE, Haissaguerre M, Helm RH, Hylek E, Jackman WM, Jalife J, Kalman JM, Kautzner J, Kottkamp H, Kuck KH, Kumagai K, Lee R, Lewalter T, Lindsay BD, Macle L, Mansour M, Marchlinski FE, Michaud GF, Nakagawa H, Natale A, Nattel S, Okumura K, Packer D, Pokushalov E, Reynolds MR, Sanders P, Scanavacca M, Schilling R, Tondo C, Tsao HM, Verma A, Wilber DJ, Yamane T (2017) 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary. J Arrhythm 33(5):369–409 - DOI

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