Cardiac rehabilitation promotes device endothelialization and reduces
peri-device leak in atrial fibrillation patients with left atrial
appendage occlusion
Abstract
Aims: Left atrial appendage (LAA) occlusion for Atrial fibrillation (AF)
is an invasive therapy to reduce stroke incidence and death. Cardiac
rehabilitation based on exercise training has become part of the
standard care for patients with heart disease. Studies are needed to
evaluate the effects of cardiac rehabilitation on exercise capacity,
cardiac function, quality of life (QoL), residual permeability, device
endothelialization and safety in AF patients with LAA occlusion.
Methods: A single-center, three-month randomized controlled trial
comparing an exercise-based cardiac rehabilitation program with a
control group was conducted. AF patients underwent LAA occlusions were
randomized to exercise-based cardiac rehabilitation (rehabilitation
group) versus usual care (control group). All patients received
assessments of echocardiography, cardiac CT, scale survey, physical
function and exercise capacity. All analyses were performed using SPSS
19.0. Results: Finally, 33 patients in control group and 30 patients in
rehabilitation group entered final analysis. The six-minute walk
distance, handgrip strength, leg strength and left ventricular systolic
function increased significantly after the study period in the
rehabilitation group compared with baseline, which have significant
interactions with control group. Significant differences between groups
were found for the mental and physical component summary scales on
SF-36, also in all of the 8 subscales. The incidence of peri-device leak
and incomplete endothelialization in cardiac rehabilitation group were
both significantly lower than that in control group. There was no
significant difference in the incidence of adverse events between the
two groups. Conclusion: Cardiac rehabilitation could promote device
endothelialization and reduce peri-device leak in AF patients with LAA
occlusion, which also has benefits in QoL, exercise capacity, physical
function and systolic left ventricular function.