Nurse-led care after ablation of atrial fibrillation: a randomized controlled trial
European journal of preventive cardiology(2023)
摘要
Aims The added value of advanced practitioner nurse (APN) care after ablation of atrial fibrillation (AF) is unknown. The present study investigates the impact of APN-led care on AF recurrence, patient knowledge, lifestyle, and patient satisfaction. Methods and results Sixty-five patients undergoing AF ablation were prospectively randomized to usual care (N = 33) or intervention (N = 32) group. In addition to usual care, the intervention consisted of an educational session, three consultations spread over 6 months and telephone accessibility coordinated by the APN. Primary outcome was the AF recurrence rate at 6-month follow-up. Secondary outcomes were lifestyle factors (alcohol intake, exercise, BMI, smoking), patient satisfaction and AF knowledge measured at 1 and 6 months between groups and within each group. Study demographics at 1 month were similar, except AF knowledge was higher in the intervention group (8.6 vs. 7, P = 0.001). At 6 months, AF recurrence was significantly lower in the intervention group (13.5 vs. 39.4%, P = 0.014). Between groups, patient satisfaction and AF knowledge were significantly higher in the intervention group, respectively, 9.4 vs. 8.7 (P < 0.001) and 8.6 vs. 7.0 out of 10 (P < 0.001). Within the intervention group, alcohol intake decreased from 3.9 to 2.6 units per week (P = 0.031) and physical activity increased from 224.4 +/- 210.7 to 283.8 +/- 169.3 (P = 0.048). No changes occurred within the usual care group. Assignment to the intervention group was the only protective factor for AF recurrence [Exp(B) 0.299, P = 0.04] in multivariable-adjusted analysis. Conclusion Adding APN-led care after ablation of AF improves short-term clinical outcome, patient satisfaction and physical activity and decreases alcohol intake. Lay Summary The present study investigates the added value of advanced practitioner nurse (APN)-led care consisting of an educational session, three consultations spread over 6 months and telephone accessibility coordinated by the APN in patients after ablation of atrial fibrillation (AF). Main findings areThe addition of nurse-led care after ablation of AF improves short-term clinical outcome, patient satisfaction and physical activity and decreases alcohol intake.Our study shows that integrating nurse-led care in the post-AF ablation setting is a relatively simple to implement, low-cost intervention with a major impact on patient outcomes and quality of care. These findings encourage including nurse-led care into routine AF ablation follow-up.
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关键词
Atrial fibrillation,advance practice nursing,nurse educator,nurse-led care,pulmonary vein isolation,recurrence
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