Mousa Alharbi1, Nicholas Giacomantonio2, Lindsey Carter2, John Sapp2, Martin Gardner2, Chris J Gray2, Amir M AbdelWahab2, Ratika Parkash3. 1. Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada; Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. 2. Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada. 3. Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada. Electronic address: Ratika.Parkash@cdha.nshealth.ca.
Abstract
BACKGROUND: Cardiac rehabilitation (CR) intervention programs are currently not part of management in patients with atrial fibrillation (AF). We sought to determine the effect of CR compared with a specialized AF clinic (AFC) and usual care on outcomes in patients with AF. METHODS: This was a single-centre retrospective cohort study that was carried out using 3 databases: the Hearts in Motion database (2010-2014), prospectively collected data in an AFC (2011-2014), and a retrospective chart review for patients in usual care (2009-2012). Three care pathways were compared: (1) CR; (2) AFC; and (3) usual specialist-based care. The main outcome was AF-related emergency department visits and cardiovascular hospitalizations. RESULTS: Of 566 patients with newly diagnosed AF, 133 (23.5%) patients underwent CR, 197 patients (34.8%) attended the AFC, whereas the remaining 236 (41.7%) were followed in a usual specialist-based care clinic. At 1 year, AF-related emergency department visits and cardiovascular hospitalization rates occurred in 7.5% in the CR group, 16.8% in the AFC group, and 29.2% in usual care. After a propensity matched analysis, usual care was associated with the highest rate of the main outcome (odds ratio, 4.91; 95% confidence interval, 2.09-11.53) compared with CR, as did the AFC compared with CR (odds ratio, 2.75; 95% confidence interval, 1.14-6.6). CONCLUSIONS: Among patients with AF, CR was associated with a lower risk of AF-related outcomes. These findings support further study of the use of CR in the management of these patients to determine the optimal model of care for AF patients.
BACKGROUND: Cardiac rehabilitation (CR) intervention programs are currently not part of management in patients with atrial fibrillation (AF). We sought to determine the effect of CR compared with a specialized AF clinic (AFC) and usual care on outcomes in patients with AF. METHODS: This was a single-centre retrospective cohort study that was carried out using 3 databases: the Hearts in Motion database (2010-2014), prospectively collected data in an AFC (2011-2014), and a retrospective chart review for patients in usual care (2009-2012). Three care pathways were compared: (1) CR; (2) AFC; and (3) usual specialist-based care. The main outcome was AF-related emergency department visits and cardiovascular hospitalizations. RESULTS: Of 566 patients with newly diagnosed AF, 133 (23.5%) patients underwent CR, 197 patients (34.8%) attended the AFC, whereas the remaining 236 (41.7%) were followed in a usual specialist-based care clinic. At 1 year, AF-related emergency department visits and cardiovascular hospitalization rates occurred in 7.5% in the CR group, 16.8% in the AFC group, and 29.2% in usual care. After a propensity matched analysis, usual care was associated with the highest rate of the main outcome (odds ratio, 4.91; 95% confidence interval, 2.09-11.53) compared with CR, as did the AFC compared with CR (odds ratio, 2.75; 95% confidence interval, 1.14-6.6). CONCLUSIONS: Among patients with AF, CR was associated with a lower risk of AF-related outcomes. These findings support further study of the use of CR in the management of these patients to determine the optimal model of care for AFpatients.
Authors: Jesse Bittman; Cynthia J Thomson; Lloyd A Lyall; Stephanie L Alexis; Eric T Lyall; Sebastian L Cannatella; Mahasti Ebtia; Alexander Fritz; Benjamin K Freedman; Nooshin Alizadeh-Pasdar; Joan M LeDrew; Teddi L Orenstein Lyall Journal: CJC Open Date: 2022-04-27
Authors: Emelia J Benjamin; Sana M Al-Khatib; Patrice Desvigne-Nickens; Alvaro Alonso; Luc Djoussé; Daniel E Forman; Anne M Gillis; Jeroen M L Hendriks; Mellanie True Hills; Paulus Kirchhof; Mark S Link; Gregory M Marcus; Reena Mehra; Katherine T Murray; Ratika Parkash; Ileana L Piña; Susan Redline; Michiel Rienstra; Prashanthan Sanders; Virend K Somers; David R Van Wagoner; Paul J Wang; Lawton S Cooper; Alan S Go Journal: J Am Heart Assoc Date: 2021-08-05 Impact factor: 6.106