Key result
Radiofrequency ablation and the 'one-stop' procedure significantly improved quality of life and cardiac function while reducing adverse events compared to drug therapy in patients with atrial fibrillation.
Why the study?
To compare the effects of different intervention measures on prognosis and quality of life in patients with atrial fibrillation to inform diagnosis and treatment.
Does radiofrequency ablation, LAAC, or a combined 'one-stop' procedure improve quality of life and cardiac function compared to drug treatment in patients with atrial fibrillation?
Observational (n=160)
Yes
Does radiofrequency ablation, LAAC, or a combined 'one-stop' procedure improve quality of life and cardiac function compared to drug treatment in patients with atrial fibrillation?
Absolute Event Rate: 15% vs 37.5%
p-value: p=<0.01
Radiofrequency ablation, alone or combined with LAAC, improves quality of life and cardiac function in AF patients compared to medical therapy, whereas isolated LAAC may worsen these outcomes and increase adverse events.
OBJECTIVE: To compare the effects of different intervention measures on prognosis and quality of life in patients with atrial fibrillation, in order to provide clinical basis for diagnosis and treatment. METHODS: A total of 160 patients who visited several hospitals including Shanghai Xinhua Hospital from June 2019 to June 2021 were selected. Among them, 40 cases were in the drug treatment group (DRUG group), 40 cases in the radiofrequency ablation group (Radiofrequency ablation, RFA group), and 40 cases in the catheter ablation combined with percutaneous left atrial appendage occlusion group (""one-stop"" procedure group) and 40 cases in the percutaneous left atrial appendage closure group (Left atrial appendage closure, LAAC group). The Minnesota quality of life score (MLHFQ), ejection fraction (LVEF), and left atrial anterior and posterior diameters (LAD) were compared between the groups at 1-year follow-up, and the differences in adverse events were compared between the groups. RESULTS: (1) After a 1-year follow-up, overall comparison, the MLHFQ scores and the LVEF and the LAD among the four groups were statistically different (p < .01); (2) Multiple comparisons, ① the MLHFQ scores: The RFA group was the lowest, the "one-stop" operation group was lower than the DRUG group, the LAAC group was the highest (p < .01). ② LVEF: The RFA group was the highest, the "one-stop" procedure group was higher than the drug treatment group, the LAAC group was the lowest (p < .01). ③ LAD: the RFA group and the "one-stop" procedure group were smaller than the DRUG group, the DRUG group was smaller than the LAAC group (p < .01).(3) Compared with the baseline data after 1-year follow-up in each group, in the RFA group and in the "one-stop" procedure group, the MLHFQ scores was decreased, the LVEF was increased, and the LAD was decreased (p < .01); in the DRUG group: the difference was not statistically significant (p > .05); in the LAAC group, the MLHFQ scores was increased, the LVEF was decreased, and the LAD was increased (p < .01). (4) There were significant differences in the incidence of adverse events among the four groups (p < .01), the lowest in the RFA group and the highest in the LAAC group. CONCLUSION: Compared with drug treatment, radiofrequency ablation and "one-stop" procedure group can improve the quality of life of patients with atrial fibrillation, improve cardiac function, and reduce the occurrence of adverse events. Percutaneous left atrial appendage occlusion affects patients' quality of life and improves cardiac function, and increases the incidence of adverse events.
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Wang et al. (2022) conducted an observational in Atrial fibrillation (n=160). Radiofrequency ablation (RFA) or 'one-stop' procedure (RFA + LAAC) vs. Drug treatment or Left atrial appendage closure (LAAC) alone was evaluated on Incidence of adverse events (p=<0.01). Radiofrequency ablation and the 'one-stop' procedure significantly improved quality of life and cardiac function while reducing adverse events compared to drug therapy in patients with atrial fibrillation.
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