초록접수 현황
| 15F-187 | 구연 발표 |
Clinical Impact of a Strict follow up Protocol on Concomitant Surgical Cryo-ablation for Atrial Fibrillation
제형곤, 박종명, 이현주, 정혜선, 이지혜, 정현희, 박수영, 이상권
부산대학교 의과대학 부산대학교병원 흉부외과학교실
Background : This study aimed to evaluate the clinical impact of a strict follow up protocol on concomitant surgical cryo-ablation for atrial fibrillation (AF).
Methods : We enrolled 145 patients who underwent concomitant surgical cryo-ablation for AF and rhythm status was checked for minimum 12 months period. Strict followed-up patients (group S, n=77) were followed up by a cardiac surgeon and electrophysiologist who adhered to a strict follow up protocol which included regular rhythm assessment and treatment of recurrent AF with antiarrhythmic agents and electrical cardioversion. Lenient followed-up patients (group L, n=68) were managed by referral hospital or unspecialized cardiologist without protocol driven management. We evaluated rhythm status at 12 and 36 months, and conducted backward logistic regression analysis to determine independent predictor of recurrence of AF at 12 months. Cross-sectional quality of life (QoL) was assessed with the Korean Short Form-36 (SF-36) survey at mean follow-up time of 39.8 ± 19.5 months.
Results : Various preoperative characteristics associated with success rate of surgical ablation were comparable between groups. At 12 month, freedom from atrial tachycardia was 90.9% in group S and 67.6% in group L (p < 0.001). The difference of sinus rhythm between groups was increased at 36 months follow up (group S: 90.3% vs. group L: 61.0%, p < 0.001). (Table 1) In multivariate analysis, independent predictors of recurrence of AF at 12 months were preoperative left atrial size (odds ratio, 1.111; 95% confidence interval, 1.051–1.174; P<0.001) and group L (odds ratio, 3.656; 95% confidence interval, 1.259–10.621; P=0.017). QoL was collected in 100 patients (group S=56, group L=44) and the majority of subscales of the SF-36 were higher in group S. The domain of physical functioning (group S: 73.8 ± 23.6 vs. group L: 60.9 ± 28.0, p=0.014) and general health (group S: 58.5 ± 19.3 vs. group L: 50.5 ± 19.9, p=0.046) was significantly higher in group S.
Conclusion : This study shows that the success rate of the surgical cryo-ablation procedure was significantly improved with strict follow up protocol by cardiac surgeon and electrophysiologist. These findings suggest that protocol guided strict follow up is essential to maintain the long-term success rate of the surgical ablation and better quality of life.
Methods : We enrolled 145 patients who underwent concomitant surgical cryo-ablation for AF and rhythm status was checked for minimum 12 months period. Strict followed-up patients (group S, n=77) were followed up by a cardiac surgeon and electrophysiologist who adhered to a strict follow up protocol which included regular rhythm assessment and treatment of recurrent AF with antiarrhythmic agents and electrical cardioversion. Lenient followed-up patients (group L, n=68) were managed by referral hospital or unspecialized cardiologist without protocol driven management. We evaluated rhythm status at 12 and 36 months, and conducted backward logistic regression analysis to determine independent predictor of recurrence of AF at 12 months. Cross-sectional quality of life (QoL) was assessed with the Korean Short Form-36 (SF-36) survey at mean follow-up time of 39.8 ± 19.5 months.
Results : Various preoperative characteristics associated with success rate of surgical ablation were comparable between groups. At 12 month, freedom from atrial tachycardia was 90.9% in group S and 67.6% in group L (p < 0.001). The difference of sinus rhythm between groups was increased at 36 months follow up (group S: 90.3% vs. group L: 61.0%, p < 0.001). (Table 1) In multivariate analysis, independent predictors of recurrence of AF at 12 months were preoperative left atrial size (odds ratio, 1.111; 95% confidence interval, 1.051–1.174; P<0.001) and group L (odds ratio, 3.656; 95% confidence interval, 1.259–10.621; P=0.017). QoL was collected in 100 patients (group S=56, group L=44) and the majority of subscales of the SF-36 were higher in group S. The domain of physical functioning (group S: 73.8 ± 23.6 vs. group L: 60.9 ± 28.0, p=0.014) and general health (group S: 58.5 ± 19.3 vs. group L: 50.5 ± 19.9, p=0.046) was significantly higher in group S.
Conclusion : This study shows that the success rate of the surgical cryo-ablation procedure was significantly improved with strict follow up protocol by cardiac surgeon and electrophysiologist. These findings suggest that protocol guided strict follow up is essential to maintain the long-term success rate of the surgical ablation and better quality of life.
책임저자: 제형곤
부산대학교 의과대학 부산대학교병원 흉부외과학교실
연락처 : 제형곤, Tel: 055-360-2127 , E-mail : jehg7332@gmail.com
