P1407Efficacy of radiofrequency ablation of paroxysmal and persistent atrial fibrillation in heart failure patients

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
S Seliutskii ◽  
N Savina ◽  
A Chapurnykh

Abstract Background radiofrequency ablation (RFA) is considered to be one of the most preferred treatments for atrial fibrillation (AFib) in patients with heart failure (HF). Objective to study the effectiveness of AFib RFA in patients with HF, to compare the effectiveness of the procedure in patients with paroxysmal (PaAFib) and persistent (PeAFib) AFib. Materials and methods 65 patients with AF and HF with LVEF < 50%, who underwent RFA were included in a prospective study. All patients underwent transthoracic echocardiography and quality of life assessment using the SF-36 questionnaire before RFA and after 12 months. AFib was recorded in 42 (65%) of patients, AFL in 23 (35%). Thirty (46%) patients had PaAfib (Group 1), and 35 (54%) PeAFib (Group 2). Results In 45 (69%) patients sinus rhythm (SR) was restored during RFA, in 15 (23%) SR was restored by electrical cardioversion. In 5 (8%) patients with PaAFib revealed SR at the time of RFA. Twelve month follow-up period revealed 49 (75%) patients who were free from AFib: 23 (77%) patients with PaAFib and 26 (74%) with PeAFib. After 12 month follow-up we revealed the improvement in LVEF (p < 0.001 in both groups), decrease of anteroposterior size of left atrium (LA) (p < 0.001 in both groups) and LA volume (p < 0.001 in both groups), improvement in the mental (p = 0.008 in Group 1; p = 0.006 in Group 2) and physical component of health according to the SF-36 questionnaire (p = 0.036 in Group 1; p = 0.049 in Group 2). There were no significant differences between two groups of follow-up period. Conclusions AFib RFA significantly improves the course of heart failure and the quality of life of patients, leads to decrease of left atrium size and increase of LVEF. The effectiveness of RFA does not depend on the type of arrhythmia in  HF patients.

2021 ◽  
Author(s):  
Serhat Yildizhan ◽  
Mehmet Gazi Boyaci ◽  
Usame Rakip ◽  
Adem Aslan

Abstract Purpose The study aimed to investigate the effects and reliability in the prevention of tumour spread of radiofrequency ablation or ablation with vertebroplasty simultaneously applied for pain in patients with painful spinal vertebra metastasis and the effect of preventing tumor spread in long-term follow-up. Methods Patients with painful vertebrae metastasis in the XXX Health Sciences University, Medical Faculty, Hospital Neurosurgery Clinic between 01.01.2015 and 01.02.2019 were recruited. They were divided into groups according to the surgical procedures applied. Group 1 included 12 patients who underwent radiofrequency ablation only, and group 2 included 16 patients who underwent vertebroplasty with radiofrequency ablation. The metastatic lesion, pain, and quality of life were evaluated with imaging, Visual Analog Scale, and Oswestry Disability Survey before and after the procedure. Results A total of 28 patients diagnosed with painful spinal metastasis were included in our study. The degree of collapse increased in five patients in group 1, leading to vertebroplasty. Simple polymethyl methacrylate leakage was observed in four patients in group 2 without spinal cord compression. Pain and quality of life improved significantly in both groups, with more being in Group 2, and analgesic use was significantly reduced. No tumor spread in the vertebrae was observed in any patient during follow-up. Conclusion According to our results, patients with painful vertebral metastases should receive vertebroplasty simultaneously with radiofrequency ablation for palliative pain control and prevention of tumour spread.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Demenko ◽  
G.A Chumakova

Abstract Background Mental disorders in patients with cardiovascular disease have a significant impact on the course, the prognosis of the underlying disease and quality of life (QOL). Objective We aimed to examine the prevalence of anxiety and depressive disorders and their impact on the quality of life in patients with atrial fibrillation (AF). Materials and methods In 52 with permanent AF and 50 with paroxysmal AF patients, we administered the depression scale Tsung, the scale of situational anxiety (SA) and personal anxiety (PA) Spielberger-Hanin; QOL was assessed the SF-36 quality of life assessment scale. Correlation analysis using Spearman's rank correlation coefficient. Results The prevalence symptoms mild depression situational or neurotic genesis was 21.1% (12 patients) in Group 1 and 12.0% (6 patients) in Group 2 (p>0.05). Subdepressive state was two percents of patients in Group 1 and Group 2. The incidence SA was 59.6% (31 patients) in Group 1 and 52.0% (26 patients) in Group 2. The incidence PA was 74.0% (37 patients) in Group 2 and 67.3% (35 patients) in Group 1. The average score the physical component of health (PCH) was 29,8±4,3 in Group 1, the mental component of health (MCH) – 49.5±7.4 points; p<0.05. In Group 2: PCH – 44.8±6.6 points, MCH – 26.6±7.5 points; p<0.05. Correlation analysis showed negative strong correlations between SA and MCH (r=−0.64, p=0.0005) and between PA and MCH (r=−0.69, p<0.0001), between SA and PCH (r=−0.71, p=0.0001), between depression and PCH (r=−0.69, p=0.023). Negative statistically significant correlation between depression and MCH (r=−0.69, p=0.54) and negative medium correlation between depression and PCH (r=−0.64, p=0.23). Conclusion These findings suggest that we did not identify patients with symptoms of a true depressive (that can cause pseudodementia and influenced to complete tests). 16.5% patients with AF had mild depression of situational or neurotic genesis. Depression may be a pathogenetic factor of AF or develop because of paroxysms AF – psychological stress. More than 50% patients in Group 1 and Group 2 had an increased anxiety score. SA is more common in patients with permanent AF, probably because older people difficult to adapt to a new situation. PA is more common in patient with paroxysmal AF, probably because disease is sudden and causes anxiety. The PCH of QOL is more impairment in patients with permanent AF, because complications (for example heart failure) impairment physical activity. However, PCH also reduced in patient with paroxysmal AF, because disease is sudden may occur during physical activity. The MCH of QOL is more impairment in patients with paroxysmal AF, because waiting attack effect on mental health and social functioning. An increased level of anxiety and depression negatively affected the mental and physical health of patients with AF. Funding Acknowledgement Type of funding source: None


2021 ◽  
Vol 7 (3) ◽  
pp. 24-27
Author(s):  
S. Tokareva ◽  
R. Kupeev ◽  
Aleksandr Hadarcev ◽  
Sof'ya Belyaeva

The purpose of the work. To show the expediency of using a complex DPN therapy with thio-gammoy-600 in combination with TPP, B12-ankerman and febuxostat. Materials and research methods. The study involved 28 male patients suffering from DM2 aged 56-77 years, with an av-erage age of 64.6±0.7 years. The initial values of average fasting blood glucose were 7.8 ± 1.52 mmol/l, glycosylated hemoglobin 7.4 ± 0.13%. Two groups were identified: group 1 (main) – 14 people and group 2 (control) - 16 people. In group 2, basic DPN therapy was used (thiogamma 600 mg/day for 4 months). For the first 14 days, the drug was administered intravenously, and then administered orally. In group 1, in addition to basic DPN therapy, B12-ankerman and febuxostat (adenuric) – 80 mg/day were received. TPP was carried out on a portable device TPP-03 for 15 minutes daily. This treatment regimen was used for 4 months. The assessment of the quality of life (QL) was carried out using the MOS SF-36 questionnaire. Results and their discussion. Four months after the start of therapy, more pronounced changes were observed in patients of the first group. The total score of the NSS scale in this group increased by 28.9%, and in group 2 - by 18.8%. The positive effect of therapy with adenuric and TES on the course of DPN shows that the use of this treatment will naturally lead to an improve-ment in the quality of life of patients, the dynamics of which was studied according to the results of the SF-36 questionnaire.


2016 ◽  
Vol 15 (1) ◽  
pp. 84-89 ◽  
Author(s):  
Ishtpreet Mann ◽  
Manisha Khubber ◽  
Ashwani K Gupta ◽  
Prithpal Singh Matreja ◽  
Harbir K Rao

Background: Diabetes mellitus and hypertension are chronic disorders, inadequate management of these two disorders leads to several complications and end organ damage that can impair health related quality of life (HRQoL) in these individuals. Several studies in hypertensive patients concluded that hypertension reduced HRQoL and participants with diabetes also reported comparably decreased HRQoL. The data on HRQoL in patients suffering from both hypertension and diabetes is limited hence we designed this study to assess health related quality of life in patients suffering from hypertension and diabetes mellitus.Methodology: This single centre, cross-sectional study was conducted for 2 months between April and August 2013 in patients with hypertension and diabetes mellitus. Patients suffering from hypertension were recruited in study and were divided into two groups, Group 1 consisted of patient suffering from hypertension and diabetes mellitus whereas Group 2 consisted of patients suffering from hypertension. Patients were assessed on Short form health Survey (SF-36) and the WHOQOL – Bref scores. Results: A total of 85 patients were screened out of which 41 patients were enrolled in the study, 21 patients in Group 1 and 20 patients in group 2. The SF-36 Scores showed significantly (p<0.05) worse pain scores in patients in Group 2. Patients in Group 1 had a better quality of life as compared to other group as evident by higher scores in most of the parameters of SF-36 and WHO-QOL Bref Score, though it was not statistically significant. Conclusion: Both groups had compromised quality of life; patients with hypertension and diabetes had a better quality of life.Bangladesh Journal of Medical Science Vol.15(1) 2016 p.84-89


EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
S Seliutskii ◽  
N Savina ◽  
A Chapurnykh

Abstract Objective to compare the efficacy of radiofrequency ablation (RFA) and drug therapy in patients with atrial fibrillation (AFib) and heart failure (HF) within 12-month follow-up. Materials and methods 130 patients (men-75%, average age-62.8 ± 11.8 years) with AFib and HF with left ventricular ejection fraction (LVEF)&lt;50% were included in a prospective study. In 107 (82%) of the included patients, intermediate LVEF was detected (40-49%). At the time of inclusion, paroxysmal AFib (PaAFib) was recorded in 60 (46%) of patients and persistent AFib (PeAFib) in 70 (54%). AFib RFA was performed in 65 patients, 65 patients continued to receive optimal antiarrhythmic therapy. Prior to the intervention and after 12 months, all patients underwent transthoracic echocardiography and quality of life (QoL) assessment using the SF-36 questionnaire. Results the freedom from AFib within 12 months follow-up period was registred in 49 (75%) of patients in the RFA group and 26 (40%) in the drug therapy group. After 12 month follow-up period we revealed increase of LVEF (p &lt; 0.001), decrease of anteroposterior size (p &lt;0.001) and volume (p &lt; 0.001) of left atrium (LA), improvement of mental (p = 0.008) and physical (p = 0.048) health components according to the SF-36 questionnaire in the RFA group. In the group of drug rhythm control, after 12 months there was only the improvement of mental (p = 0.006) and physical p = 0.016) health components and it was much less than in RFA group (р&lt;0.001). Similar results were received in patients who were free from Afib within 12 months in both groups. Conclusions in patients with AFib and HF with LVEF &lt; 50%, restoration and maintenance of sinus rhythm using RFA was accompanied by an increase in LVEF, decrease of  LA size, and an improvement of QoL. In the group of drug therapy, there was a lower freedom from AFib and there was the slight improvement only in QoL.


2016 ◽  
Vol 94 (2) ◽  
pp. 138-143
Author(s):  
Ludmila A. Belova ◽  
V. V. Mashin ◽  
V. V. Abramova ◽  
A. N. Proshin ◽  
A. N. Ovsyannikova

Aim. To study the neuroprotective effect of a repeated course of low dose cortexin therapy on the quality of life in the early rehabilitative period after hemispheric ischemic stroke (IS). Materials and methods. 90 patients were divided into group 1 treated with cortexin (10 mg i/m twice daily (morning and afternoon) in addition to basal treatment, group 2 given the repeated course of the same treatment, and control group (basal therapy alone). The standard SF-36 questionnaire was used to assess the quality of life. Results. Treatment of patients following acute hemispheric ischemic stroke with cortexin (10 mg i/m twice daily) and the repeated course of the same treatment after 10 days resulted in the accelerated and more complete normalization of the quality of life in the early rehabilitation petriod (starting from days 21-27 days after the onset of disease) than in the patients given a single course of cortexin therapy or basal treatment alone.


Author(s):  
N. L. Perelman

Aim. To compare the nature and degree of influence of different types of airway hyperresponsiveness (AHR) on the general and specific quality of life (QoL) of patients with asthma and control over the disease.Materials and methods. 234 patients with mild-to-moderate asthma, aged from 18 to 60 years old, were interviewed and examined. Depending on the presence of one or another type of AHR, 4 groups were formed: group 1 included 60 patients with cold AHR, group 2 – 75 patients with hypoosmotic AHR, group 3 – 35 patients with hyperosmotic AHR, group 4 – 64 patients with exercise-induced bronchoconstriction (EIB). QoL and the state of the emotional sphere were assessed using the SF-36, AQLQ, HADS questionnaires. The level of asthma control was determined using the ACT questionnaire. Lung function was assessed by spirometry.Results. When comparing QoL between groups, statistical differences were obtained for most of the SF-36 scales, with the exception of the domains “Role Physical” (RP) and “Bodily Pain” (BP), and their presence and significance varied depending on the types of AHR being compared. The lowest QoL indices were found in group 1 of patients with cold AHR according to the domains “Physical Activity” (PA), RP, BP, and “Role Emotional” (RE). The lowest indices for the domains “General Health” (GH), “Vitality” (V) and “Mental health” (MH) were found in the respondents of the 2nd group. Most of the highest QoL indicators in the compared groups were found in patients of group 4 with EIB in the domains PA, RP, V, RE, and MH. When carrying out a comparative analysis, the maximum number of significant differences was found between the groups with cold AHR and EIB. A comparative study of QoL using a special AQLQ questionnaire showed the lowest indices for the “Activity” and “Symptoms” domains in groups 1 and 2 of asthma patients. In addition, in group 1, the minimum QoL values were recorded for the “General QoL” domain (3.6±0.2 points), and in group 2, for the “Environment” domain (2.9±0.3 compared with 3.9±0.2 points in group 3, p<0.01).Conclusion. This study has demonstrated the multifaceted effect of AHR on health-related QoL, dependent on sensitivity to a particular physical stimulus and the season of maximum trigger action. The subjective assessment of psychosocial functioning is most differentiated according to the GH domain of the SF-36 questionnaire. The greatest negative impact on the QoL indices is exerted by the cold and hypoosmotic AHR, the least – by the EIB. The assessment of QoL allows to get a full picture of the perception of the patient's health level at the moment and in the given conditions.


Genes ◽  
2022 ◽  
Vol 13 (1) ◽  
pp. 118
Author(s):  
Luis Alfredo Utria Acevedo ◽  
Aline Morgan Alvarenga ◽  
Paula Fernanda Silva Fonseca ◽  
Nathália Kozikas da Silva ◽  
Rodolfo Delfini Cançado ◽  
...  

Background: Hemochromatosis is a genetic condition of iron overload caused by deficiency of hepcidin. In a previous stage of this study, patients with suspected hemochromatosis had their quality of life (QL) measured. We observed that QL scores differed among genotypic groups of patients. In this reported final phase of the study, the aims were to compare QL scores after a treatment period of approximately 3 years and to analyze a possible association of the serum ferritin values with QL scores. Methods: Sixty-five patients were enrolled in this final phase and divided into group 1 (patients that showed primary iron overload and homozygous genotype for the HFE p.Cys282Tyr mutation) and group 2 (other kinds of genotypes). Short Form 36 (SF-36) was performed and consisted of eight domains with a physical and also a mental component. Results: Both groups had a significant decrease in serum ferritin concentrations: group 1 had a variation from 1844 ± 1313 ng/mL to 281 ± 294 ng/mL, and group 2 had a variation from 1216 ± 631 ng/mL to 236 ± 174 ng/mL. Group 1 had a smaller mean value for these six SF-36 domains compared with group 2, indicating a worse QL. Conclusions: In this final stage, six domains demonstrated a difference among genotypic groups (role emotional and mental health, adding to the four of the initial phase), reassuring the impact of the identified genotype on the QL of hemochromatosis patients. Furthermore, despite that both patient groups demonstrated similar and significant decreases in serum ferritin values, no association was found between the decrease in this biological parameter and the SF-36 domains.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16071-e16071
Author(s):  
Benjamin Guix ◽  
Teresa Maria Lacorte ◽  
Jose Maria Bartrina ◽  
Jose Ignacio Tello ◽  
Ines Guix ◽  
...  

e16071 Background: To report long term Health Related Quality of Life (HRQoL) in a prospective series of 629 patients with intermediate or high-risk clinically localized prostate cancer treated with either IMRT or IMRT + HDR. Methods: Between December 1999 and December 2010, 629 patients (pts) with PSA›10, Gleason score›6 and/or T2b-T3 N0 M0 prostate cancer entered the study. Pts were prospectively assigned to one of the two treatment groups: 76 Gy HD-3D-IMRT to the prostate in 38 fractions (group 1; 315 patients) or 46 Gy LD-3D-CRT+ 16 Gy HDR-B given in 2 fractions of 8 Gy (group 2, 316 patients), limiting the maximum rectal dose to 85% of the prescribed dose. Both groups were well balanced taking into account patient’s as well as tumors’ characteristics. Toxicities were scored by the EORTC /RTOG morbidity grading scales. Special attention to local, regional or distant recurrence, survival, late effects, PSA and testosterone levels as well as HRQOL was done. Results: All pts completed treatment. None pts included in group 1 or 2 had grade 3 or more rectal toxicity. With a mean follow-up of 96 m, the 8-year free-from-failure survival was 90.7% and 98.3% (p<0.02) in group 1 and 2 respectively; free-from-metastases survival 96.9% and 97.9% (p<0,08)for group 1 and 2; and cause-specific survival 97.4% and 98.3% (p<0.09). HRQoL was evaluated before treatment, at 3 months interval during the first year follow up and in a yearly basis until 10-year. I-PSS and EORTC’s QLQ-C30 with PR-25 were used. I-PSS scores at 1, 3 and 6 months and at 1, 2, 3, 5 and 8 years follow-up were 6.39, 5.00, 2.52, 2.21, 2.35, 3.65 and 1.43 for group 1 pts and 1.50, 1.10, 1.01, 1.05, 0.89, 0.66, 0.67 for group 2 pts. Global HRQoL scores at 1, 3 and 6 months and at 1, 2, 3 and 5 years follow up were 5.56, 5.75, 5.33, 6.00, 5.40, 5.58 and 5.11 for group 1 pts and 5.60, 6.40, 5.78, 5.89, 5.83, 6.37, 6.00 for group 2 pts, being found to be statistically significant at 3 and 5 years follow up (p<0,001 and p<0,024). Conclusions: High-dose 3D-IMRT + HDR brachytherapy was found to be a method of escalating the dose to the prostate that not only increased the chances of cure for patients if not increased their long-term Health Related Quality of Life.


Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3810-3810
Author(s):  
Mauricette Michallet ◽  
Karine Goldet ◽  
Stephane Morisset ◽  
Mohamad Sobh ◽  
Youcef Chelghoum ◽  
...  

Abstract Abstract 3810 Introduction: Despite frequent anemia and multiple transfusions during AML chemotherapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT), recommendations and marketing authorization for erythropoietin (EPO) use are still missing. In the current prospective study, as primary objective, we evaluated the effect of EPO on patient's quality of life (QOL). Secondary objective was hemoglobin (Hb) recovery. In addition, a paired matched analysis using similar population was conducted to compare platelets (Pt) and red blood cells (RBC) transfusion number. Materials and methods: We included adult patients with Hb level ≤11g/dl induced by 1, 2 or 3 consolidation chemotherapy for AML in complete remission (CR) (group 1); or by allo-HSCT for any hematological disease (group 2). EPO was administered Sc. once per week during a maximum period of 6 months: for group 1, ARANESP® 150μg; for group 2, NEORECORMON® 30000IU; Hb level was monitored every week. Injections were stopped once the Hb level reached 12g/dl without any transfusion. If after 4 injections, no improvement was observed, doses were doubled, and if after 8 injections, no improvement was observed, patient was taken off-study for EPO inefficiency. The QOL was measured at baseline, at 1, 2, 3 and 6 months by the Functional Assessment of Cancer Therapy–Anemia (FACT–An). EPO responders patients were defined as having Hb level ≥12g/dl (EPO CR) or a ≥ 2g/dl increase [EPO partial response (EPO PR)] compared with baseline value without any transfusion requirement. The matching analysis took into account: sex, age, disease status, for the two groups, associated to cytogenetics, type of chemotherapy, sequential chemotherapy number for group 1, and diagnosis, conditioning, HSC source, number of previous transplants and GVHD for group 2. Results: Between April 2006 and December 2009, among 261 screened patients, 55 were included in group1 and 61 in group 2, patient characteristics for each group are summarized in Table1. Main exclusion criteria were EPO contra-indication and patient refusal. The median number of EPO injections/patient was 13 (3 – 24) in group1 and 8 (2 - 28) in group 2. For the global population (111 evaluable patients [52 group1 and 59 in group 2]), we have noticed a significant improvement of QOL during the 6 months follow-up according to FACT-An anemia (p=0.01). Despite a non-significant improvement for FACT-G, we observed a significant improvement in physical well-being (p<0.0001). There were 85 EPO CR (83% in group1 and 71% in group 2) and 3 (6%) EPO PR (only in group1). Among patients who reached the 6 months follow-up, 81% had a normal Hb level. Fourteen patients (13%) were withdrawn (6 in group1 and 8 in group 2) due to EPO inefficacy and 9 in group 2 for relapse or EPO related/unrelated serious adverse events (AEs). In group1: the median time to achieve an EPO CR was 34 days (17-67) after first consolidation and 41 days (12-67) after second consolidation (p=0.35). In group 2: the median time to achieve EPO CR was 39 days (14 - 180). After the pair-matched analysis, 44 patients in each group were matched with at least one case-control patient. When comparing RBC and Pt transfusions, there were 712 units and 751 units in the matched population versus 504 and 669 in the EPO population respectively [208 spared RBC (80 in group1, p=0.008 and 128 in group 2, p=0.004) and 100 spared Pt units (all in group1, p=0.001)]. The multivariate analysis studying different confounding factors on the cumulative incidence of EPO CR showed a significant positive impact of younger age (p=0.001) and intensive chemotherapy (p=0.03) in group1; and for group 2, the positive impact of Pt levels at baseline, the negative impact of female recipient and major ABO incompatibility. We did not find any significant difference in terms of overall (OS) and event free survival (EFS) between EPO and control groups. Conclusion: This prospective study showed a real benefit of EPO administration on QOL, an achievement of a normal Hb level and a significant spare of RBC and Pt transfusions. Young AML patients, male allo-HSCT recipient, ABO compatible pairs seem to be the best candidates to benefit from EPO administration, with low AEs and no impact on OS or EFS. A cost-effectiveness study is ongoing and results will be communicated. Disclosures: No relevant conflicts of interest to declare.


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