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Minimally Symptomatic Atrial Fibrillation Patients Derive Significant Symptom Relief Following Rate Control or Rhythm Control Therapy.

King DR, Mehta ND, Gehi AK, Pursell I, Mounsey P, Kumar P, Bamimore A, Chung EH - J Clin Med Res (2015)

Bottom Line: In our cohort, the revised pre-intervention CCS-SAF score was 1.69 ± 1.36 and the post-intervention CCS-SAF score was 0.52 ± 0.80.Thirty-seven patients reported symptom improvement; those who improved were on average 72.4% improved from baseline.We conclude asymptomatic to minimally symptomatic AF patients benefit from therapy and should be offered intervention despite lack of symptoms.

View Article: PubMed Central - PubMed

Affiliation: UNC Center for Heart and Vascular Care, Department of Medicine, Cardiac Electrophysiology, University of North Carolina at Chapel Hill, NC, USA.

ABSTRACT

Background: It can be challenging to convince asymptomatic to minimally symptomatic patients to pursue treatment of their atrial fibrillation (AF). We hypothesized that once in sinus rhythm, asymptomatic to minimally symptomatic patients would realize they were compensating for moderate symptoms, and that we could quantify this via the Canadian Cardiovascular Society Severity of AF (CCS-SAF) score.

Methods: All patients in our study come from the Symptom Mitigation in Atrial Fibrillation (SMART) study. Upon enrollment all patients were assigned a CCS-SAF score. Patients receiving a CCS-SAF score of 0 or 1 that elected to pursue intervention were contacted by phone and asked about their symptoms post-intervention as compared to pre-intervention. Paired t-test was used for analysis.

Results: Out of 800 patients in the SMART study to date, 48 patients have qualified for our phone survey and presented for follow-up in our clinic. In our cohort, the revised pre-intervention CCS-SAF score was 1.69 ± 1.36 and the post-intervention CCS-SAF score was 0.52 ± 0.80. Thirty-seven patients reported symptom improvement; those who improved were on average 72.4% improved from baseline.

Conclusions: We conclude asymptomatic to minimally symptomatic AF patients benefit from therapy and should be offered intervention despite lack of symptoms.

No MeSH data available.


Related in: MedlinePlus

Summarization of treatment effect on CCS-SAF score in subpopulations in our low SAF cohort. (a) Our subpopulations of rhythm control (n = 30) and rate control (n=18). (b) Our subpopulations of persistent AF (n = 14) and paroxysmal AF (n = 34).
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Figure 1: Summarization of treatment effect on CCS-SAF score in subpopulations in our low SAF cohort. (a) Our subpopulations of rhythm control (n = 30) and rate control (n=18). (b) Our subpopulations of persistent AF (n = 14) and paroxysmal AF (n = 34).

Mentions: Furthermore, we examined CCS-SAF score improvement in patients who received rate control (18 patients), versus those who received rhythm control (30 patients). In both populations significant CCS-SAF score improvement was observed (P = 0.005 and P < 0.0001 respectively) (Fig. 1a). Also, we examined CCS-SAF improvement in patients suffering from paroxysmal AF and persistent AF at baseline. Again, in both populations significant CCS-SAF score improvement was observed (P = 0.0002 and P = 0.007 respectively) (Fig. 1b).


Minimally Symptomatic Atrial Fibrillation Patients Derive Significant Symptom Relief Following Rate Control or Rhythm Control Therapy.

King DR, Mehta ND, Gehi AK, Pursell I, Mounsey P, Kumar P, Bamimore A, Chung EH - J Clin Med Res (2015)

Summarization of treatment effect on CCS-SAF score in subpopulations in our low SAF cohort. (a) Our subpopulations of rhythm control (n = 30) and rate control (n=18). (b) Our subpopulations of persistent AF (n = 14) and paroxysmal AF (n = 34).
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4522986&req=5

Figure 1: Summarization of treatment effect on CCS-SAF score in subpopulations in our low SAF cohort. (a) Our subpopulations of rhythm control (n = 30) and rate control (n=18). (b) Our subpopulations of persistent AF (n = 14) and paroxysmal AF (n = 34).
Mentions: Furthermore, we examined CCS-SAF score improvement in patients who received rate control (18 patients), versus those who received rhythm control (30 patients). In both populations significant CCS-SAF score improvement was observed (P = 0.005 and P < 0.0001 respectively) (Fig. 1a). Also, we examined CCS-SAF improvement in patients suffering from paroxysmal AF and persistent AF at baseline. Again, in both populations significant CCS-SAF score improvement was observed (P = 0.0002 and P = 0.007 respectively) (Fig. 1b).

Bottom Line: In our cohort, the revised pre-intervention CCS-SAF score was 1.69 ± 1.36 and the post-intervention CCS-SAF score was 0.52 ± 0.80.Thirty-seven patients reported symptom improvement; those who improved were on average 72.4% improved from baseline.We conclude asymptomatic to minimally symptomatic AF patients benefit from therapy and should be offered intervention despite lack of symptoms.

View Article: PubMed Central - PubMed

Affiliation: UNC Center for Heart and Vascular Care, Department of Medicine, Cardiac Electrophysiology, University of North Carolina at Chapel Hill, NC, USA.

ABSTRACT

Background: It can be challenging to convince asymptomatic to minimally symptomatic patients to pursue treatment of their atrial fibrillation (AF). We hypothesized that once in sinus rhythm, asymptomatic to minimally symptomatic patients would realize they were compensating for moderate symptoms, and that we could quantify this via the Canadian Cardiovascular Society Severity of AF (CCS-SAF) score.

Methods: All patients in our study come from the Symptom Mitigation in Atrial Fibrillation (SMART) study. Upon enrollment all patients were assigned a CCS-SAF score. Patients receiving a CCS-SAF score of 0 or 1 that elected to pursue intervention were contacted by phone and asked about their symptoms post-intervention as compared to pre-intervention. Paired t-test was used for analysis.

Results: Out of 800 patients in the SMART study to date, 48 patients have qualified for our phone survey and presented for follow-up in our clinic. In our cohort, the revised pre-intervention CCS-SAF score was 1.69 ± 1.36 and the post-intervention CCS-SAF score was 0.52 ± 0.80. Thirty-seven patients reported symptom improvement; those who improved were on average 72.4% improved from baseline.

Conclusions: We conclude asymptomatic to minimally symptomatic AF patients benefit from therapy and should be offered intervention despite lack of symptoms.

No MeSH data available.


Related in: MedlinePlus