The burden of atrial fibrillation (AF) in China is increasing, and catheter ablation has become a first-line treatment. The perioperative symptom clusters of AF patients undergoing catheter ablation are complex and diverse, closely related to patients´ quality of life, disease prognosis, and healthcare resource utilization, and therefore, warrant significant attention. This paper systematically reviews the research related to the perioperative symptom clusters of AF patients undergoing catheter ablation. It introduces the types and current status of these symptom clusters, summarizes the influencing factors of perioperative symptom clusters, organizes the assessment tools for AF symptom clusters, and finally elucidates the management strategies for perioperative symptom clusters in AF patients. The goal is to provide insights for developing innovative comprehensive management models for perioperative symptom clusters in AF patients.
Physical activity is the focus of disease management in patients with atrial fibrillation (AF), and different types and intensities of physical activity have different impacts on the health status of patients; however, the current distribution of physical activity types in patients with AF is not clearly characterized.
To explore differences in the distribution of the daily physical activity energy expenditure in patients with AF and the influencing factors.
A total of 300 AF patients newly admitted to the Department of Cardiology Medicine at the First Affiliated Hospital with Nanjing Medical University for elective catheter ablation from July to December 2023 were enrolled. General patient information was collected. The International Physical Activity Questionnaire-Long Form (IPAQ-L) was used to assess the level of physical activity, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) to evaluate fear of disease progression, the Cancer Acceptance Scale-Revised (CAS-R) to assess perceived control, and the Family Apathy Index (FAI) to gauge family care. A latent profile analysis was conducted on energy expenditure from various types of physical activity among AF patients. Starting from a one-class model, the number of classes was incrementally increased to determine the best-fitting model. Multivariate Logistic regression analysis was employed to investigate the impact of various factors on different latent profiles.
Based on IPAQ-L scores, 80 patients (26.7%) had low, 63 (21.0%) had moderate, and 157 (52.3%) had high levels of physical activity. The latent profile analysis of patients' physical activity energy expenditure categorized them into two profiles: low energy expenditure-primarily sedentary (n=198) and high energy expenditure-primarily occupational physical activity (n=102). Univariate analysis revealed statistically significant differences in age, education level, occupation, family monthly income per capita, and scores on the FoP-Q-SF, CAS-R, and FAI between the two profiles (P<0.05). Multivariate Logistic regression analysis indicated that age 40-59 years (OR=0.280, 95%CI=0.087-0.899, P=0.017), bachelor's degree or higher (OR=0.331, 95%CI=0.124-0.883, P=0.027), mental labor (OR=0.315, 95%CI=0.121-0.817, P=0.032), retirement (OR=0.151, 95%CI=0.050-0.452, P<0.001), FoP-Q-SF score (OR=1.086, 95%CI=1.036-1.139, P<0.001), CAS-R score (OR=0.899, 95%CI=0.820-0.985, P=0.022), and FAI score (OR=0.828, 95%CI=0.707-0.969, P=0.018) were influencing factors of the latent profiles of physical activity (PA) energy expenditure (P<0.05) .
There are different latent profiles of physical activity energy expenditure among AF patients, with heterogeneous distribution characteristics across profiles. Patients aged 40-59, with bachelor's degree or higher, engaged in mental labor, retired, possessing strong perceived control, and receiving high family care are more likely to be classified as low energy expenditure-primarily sedentary. Interventions can be tailored based on the characteristics of different physical activity energy expenditure profiles and influencing factors to promote appropriate and scientific physical activity.
Although exercise rehabilitation has been proven to be safe and effective for cardiovascular patients, compliance remains suboptimal. The sustained benefits of exercise are closely related to compliance, yet current research has failed to delineate the relationship between exercise compliance and the recurrence of atrial fibrillation (AF) in patients undergoing radiofrequency ablation.
To investigate the impact of adherence to home-based exercise rehabilitation programs and other relevant factors on the recurrence of atrial fibrillation in patients following radiofrequency ablation.
Convenience sampling was used to select patients with AF who underwent radiofrequency ablation surgery in the Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University from May to November 2020. Patients routinely underwent a 6-minute walk test, balance and flexibility assessments, and cardiopulmonary exercise testing, and individualized exercise prescriptions were formulated based on the assessment results. General patient data were collected, and exercise rehabilitation compliance was assessed using the Cardiac Rehabilitation Inventory (CRI) to evaluate the cardiac rehabilitation needs and willingness of patients with cardiovascular diseases, and the Patient Activation Measure (PAM13) was used to measure the level of knowledge, skills, behaviors, and confidence in participating in their own health management and health care during the disease diagnosis and treatment process. Compliance data on intensity-time and frequency were followed up at the 1st week, 3rd month, 6th month, 9th month, and 12th month. The generalized estimating equations (GEE) model was used to explore the influencing factors of the recurrence of AF in patients after radiofrequency ablation surgery.
A total of 151 patients aged 29 to 84 years, with an average age of (61.7±11.0) years, and 23 patients experienced a recurrence of AF. The changes in intensity-time compliance and frequency compliance of AF patients after radiofrequency ablation surgery at different follow-up stages were statistically significant (P<0.05). After controlling for time, BMI, smoking, type of AF, activation, process anxiety, and outcome anxiety, the GEE analysis showed that intensity-time compliance≥100% was a protective factor for the recurrence of AF after radiofrequency ablation surgery (P<0.05) .
The compliance with home-based exercise rehabilitation in AF patients after radiofrequency ablation surgery changes over time, and it is recommended that clinical medical staff pay attention to the guidance and supervision of exercise intensity, take targeted measures to reduce process and outcome anxiety, in order to more effectively improve patient outcomes through exercise rehabilitation.
