A comparison of the real world effectiveness of catheter ablation and drug therapy in atrial fibrillation patients in a Chinese setting

BMC Cardiovascular Disorders

Research Article

Xin Du¹  Ronghui Yu¹  Xiaonan He¹  Jianzeng Dong¹  Caihua Sang¹  Deyong Long¹  Jiahui Wu¹  Lizhu Guo¹  Changsheng Ma¹  Xiaohui Liu¹  Hongjun Yin²  Jianwei Xuan³  Yu Jia⁴ 

[1] Beijing Anzhen Hospital, Capital Medical University, No 2 Anzhen Road, Chaoyang District, 100029, Beijing, China;Shanghai Centennial Scientific Ltd., Inc., Shanghai, China;Shanghai Centennial Scientific Ltd., Inc., Shanghai, China;Health Economic Research Institute, Sun-Yat-sen University, Zhongshan, Guangdong, China;Strategic Medical Affairs, Johnson & Johnson Medical (China) Ltd., Shanghai, China;

关键词: Catheter ablation;    Atrial fibrillation;    Anti-arrhythmic drugs;    Quality of life;    Chinese;   

DOI  :  10.1186/s12872-017-0634-y

 received in 2017-03-01, accepted in 2017-07-18,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundStudies have demonstrated that catheter ablation of atrial fibrillation is associated with better rhythm control than drug therapy. The present study aimed to assess the clinical outcomes and health-related quality of life of ablation therapy in a real world setting.MethodsA prospective, non-randomized, single center study in a real-world clinical setting in China was conducted. Patients were followed up at 3, 6, and 9 months after baseline encounter. Propensity score matched patients receiving ablation or anti-arrhythmic drug therapy were compared. Incidence rate of atrial fibrillation recurrence and quality of life outcomes were measured and analyzed using log-rank test, multivariate logistic regression and mixed-effects linear regression respectively.ResultsIn this study, 151 atrial fibrillation patients treated by ablation therapy and 318 patients treated by anti-arrhythmic drugs were enrolled. During follow up, 82.0% in the ablation arm and 22.4% in the drug arm had no documented atrial fibrillation recurrence [HR for atrial fibrillation recurrence 0.07 (95%CI: 0.02–0.21, p < 0.0001)] among paroxysmal atrial fibrillation patients. The corresponding no recurrent rate were 66.7% and 18.5% [0.21 (0.05–0.95, p = 0.04)] respectively among persistent atrial fibrillation patients. Improvement in Short Form-36 physical component scores, Short Form-36 mental component scores and total Atrial Fibrillation Effect on Quality-of-life scores were 16.33 (14.05–18.61, p < 0.001), 8.10 (6.11–10.09, p < 0.001) and 18.28 (16.11–20.45, p < 0.001) respectively among paroxysmal AF patients and 6.32 (3.15–9.49, p < 0.001), 3.99 (1.82–6.16, p < 0.001) and 13.97 (10.89–17.05, p < 0.001) respectively among persistent AF patients. Improvements in total Atrial Fibrillation Effect on Quality-of-life score were also significant in ablation arm while no significant improvement of total Atrial Fibrillation Effect on Quality-of-life score in the drug arm.ConclusionCompared with drug therapy, catheter ablation is associated with significant lower AF recurrence and improved overall quality of life.Trial registrationThe present study has been registered on clinicaltrials.gov. The ClinicalTrials.gov ID is NCT01878981. The registration date is May 29, 2013.

【 授权许可】

CC BY   
© The Author(s). 2017