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Catheter ablation f...
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Björkenheim, Anna,1980-Örebro universitet,Institutionen för medicinska vetenskaper
(författare)
Catheter ablation for atrial fibrillation : effects on rhythm, symptoms and health-related quality of life
Förlag, utgivningsår, omfång ...
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Örebro :Örebro University,2018
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92 s.
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electronicrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:oru-65015
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ISBN:9789175292373
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-65015URI
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Språk:engelska
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Sammanfattning på:engelska
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Klassifikation
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Ämneskategori:vet swepub-contenttype
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Ämneskategori:dok swepub-publicationtype
Serie
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Örebro Studies in Medicine,1652-4063 ;175
Anmärkningar
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Background: AF ablation is an increasingly used treatment in patients with AF to improve patient-reported outcomes (PROs). Atrioventricular junction ablation (AVJA) is a palliative treatment option in therapy refractory AF that improves PROs but renders the patient pacemaker dependent.Aims: To evaluate rhythm control and PROs before and up to two years after AF ablation. To analyze the long-term incidence of and predictors of hospitalization for HF and all-cause mortality in patients who underwent AVJA and right ventricular pacing.Methods and Results: Fifty-four patients underwent AF ablation and both continuous rhythm monitoring via an implantable loop recorder (ILR) and intermittent rhythm monitoring three, six, 12 and 24 months after ablation. 76 % of patients had at least one AF recurrence, of whom 24 % were only detected by ILR. One third of symptom recordings did not show AF. The AF-specific AF6 scores, physician-assessed EHRA symptom class and both SF-36 summary scores all improved significantly from before to two years after ablation. There was a weak correlation between the change in AF6 scores and EHRA class from before to six and 12 months but not to 24 months after ablation. Responders to ablation (AF burden < 0.5 %), reached age- and sex-matched norms in all SF-36 domains, but non-responders only in social functioning and MCS. All AF6 scores showed at least moderate improvement in both responders and non-responders. Higher AF burden was independently associated with poorer PCS and AF6 scores. In 162 patients who underwent AVJA, hospitalization for HF occurred in 20 % of patients (two-year cumula-tive incidence 9.1 %) and 22 % died (two-year cumulative incidence 5.2 %) during a median follow-up of five years. QRS ≥ 120 ms and left atrial diame-ter were independent predictors of hospitalization for HF, and hypertension and previous HF of death.Conclusions: Continuous rhythm monitoring was superior to intermittent monitoring. The AF-specific AF6 was more sensitive to changes related to AF burden after AF ablation than both EHRA class and the SF-36. The long-term hospitalization rate for HF and all-cause mortality was low after AVJA.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Poçi, Dritan,Medicine doktor,1969-Örebro universitet,Institutionen för medicinska vetenskaper(Swepub:oru)dnpi
(preses)
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Lane, Deirdre,ProfessorInstitute of Cardiovascular Sciences, University of Birmingham
(opponent)
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Örebro universitetInstitutionen för medicinska vetenskaper
(creator_code:org_t)
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