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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

34.6K

Cardiac prehabilitation, rehabilitation and education in first-time atrial fibrillation (AF) ablation (CREED AF):

Nakul Chandan1,2, Violet Matthews1,3, Hejie He1,4

  • 1Institute for Cardio-Metabolic Medicine, University Hospital Coventry, Coventry, United Kingdom.

Plos One
|October 3, 2024
PubMed

Insights

This study investigates a comprehensive prehabilitation and rehabilitation program combined with risk factor modification for atrial fibrillation (AF) patients undergoing ablation. The program aims to improve patient outcomes and cost-effectiveness compared to standard care.

Area of Science:

  • Cardiology
  • Clinical Trials
  • Preventive Medicine

Background:

  • Atrial fibrillation (AF) presents significant morbidity and mortality risks.
  • First-time AF ablation success rates vary (40-80%), highlighting the need for improved patient management.
  • Evidence suggests managing AF risk factors through education and exercise improves outcomes, but combined prehabilitation/rehabilitation has not been studied.

Purpose of the Study:

  • To assess the efficacy of a comprehensive prehabilitation and rehabilitation program combined with risk factor modification and education for patients undergoing first-time AF ablation.
  • To compare this intervention against standard care in a randomized controlled trial.
  • To evaluate the cost-effectiveness of the intervention.

Main Methods:

  • A single-centre pragmatic randomized controlled trial involving 106 adults with AF undergoing first-time ablation.
  • Participants randomized to either the cardiac prehabilitation/rehabilitation/education (CREED AF) intervention or standard care.
  • The CREED AF intervention includes 6 weeks of prehabilitation and 6 weeks of rehabilitation with supervised exercise and risk factor management; standard care involves a single risk factor education session.

Main Results:

  • Primary outcome: cardiorespiratory fitness (VO2peak) measured by CPET at 10 weeks post-ablation.
  • Secondary outcomes: quality of life, AF recurrence/burden (7-day Holter), repeat ablation rates, major adverse cardiovascular events, and cost-effectiveness (QALY).
  • Outcomes assessed at baseline, 10 weeks, and 12 months by blinded researchers.

Conclusions:

  • This study will determine the clinical efficacy and cost-effectiveness of comprehensive prehabilitation, rehabilitation, and patient education for first-time AF ablation patients.
  • Results are expected to inform clinical practice and future multi-centre trial designs.
  • The findings will contribute to optimizing AF management strategies.
Abstract

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