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Published on: February 26, 2013
Cardiac Rehabilitation in Atrial Fibrillation Patients With Left Atrial Appendage Occlusion: A RANDOMIZED TRIAL
Yucheng Wu1, Jie Lin, Benbingdi Gong
1Department of Cardiology, Taizhou People's Hospital, Taizhou, Jiangsu, China.
Insights
Cardiac rehabilitation (CR) improves quality of life and exercise capacity in patients with atrial fibrillation (AF) after left atrial appendage (LAA) occlusion. CR also accelerates device endothelialization, enhancing safety and recovery.
Area of Science:
- Cardiology
- Interventional Cardiology
- Rehabilitation Medicine
Background:
- Left atrial appendage (LAA) occlusion is a key therapy for reducing stroke risk in atrial fibrillation (AF).
- The role of cardiac rehabilitation (CR) in patients undergoing LAA occlusion is not well-established.
- Investigating CR's impact is crucial for optimizing post-procedural care.
Purpose of the Study:
- To assess the effects and safety of exercise-based CR in patients with AF following LAA occlusion.
- To evaluate CR's influence on device endothelialization, physical function, and quality of life.
Main Methods:
- A 6-month, single-center randomized controlled trial comparing exercise-based CR with usual care.
- Patients with AF who underwent LAA occlusion were randomized.
- Assessments included echocardiography, CT, functional tests, and exercise capacity at baseline and follow-up.
Main Results:
- The CR group showed significant improvements in 6-minute walk test, strength, and left ventricular ejection fraction.
- Quality of life scores (SF-36) improved significantly in both mental and physical components with CR.
- Incomplete device endothelialization was significantly lower in the CR group at 3 and 6 months.
Conclusions:
- Cardiac rehabilitation accelerates device endothelialization post-LAA occlusion in AF patients.
- CR significantly enhances quality of life, exercise capacity, and physical function.
- CR is a safe and effective adjunctive therapy for AF patients with LAA occlusion.
Purpose:
Left atrial appendage (LAA) occlusion for atrial fibrillation (AF) is an invasive therapy that reduces stroke incidence and death. The impact of cardiac rehabilitation (CR) on patients with AF with LAA occlusion remains unknown. We aimed to evaluate the effects and safety of CR in patients with AF with LAA occlusion.
Methods:
This 6-mo single-center randomized controlled trial compared an exercise-based CR program with a control group. Patients with AF who underwent LAA occlusion from December 2018 to December 2020 were randomized into two groups: exercise-based CR and usual care (control). All patients underwent echocardiography, cardiac computed tomography, scale survey, physical function, and exercise capacity at baseline and at 3 and 6 mo follow-up.
Results:
There were 33 and 30 patients in the control and CR groups, respectively, in the final analysis. After the study period, the 6-min walk test distance, handgrip and leg strength, and left ventricular ejection fraction increased significantly in the CR group compared with baseline. Significant between-group differences were found in the mental and physical component summary scales, including all eight subscales, of the Short Form 36. The incidence of incomplete endothelialization in the CR group at 3 and 6 mo was significantly lower than that in the control group.
Conclusions:
Cardiac rehabilitation was shown to accelerate device endothelialization in patients with AF with LAA occlusion, while also improving the quality of life, exercise capacity, and physical function.
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