233 Concomitant Surgical Atrial Fibrillation Ablation Follow-Up Against Best-Practice Standards at A Tertiary Cardiac Surgery Centre in Brighton
| Autor: | Michael E. Lewis, A Hussain, G Kugan, Sarabjot Singh |
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| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | British Journal of Surgery. 108 |
| ISSN: | 1365-2168 0007-1323 |
| DOI: | 10.1093/bjs/znab134.386 |
| Popis: | Introduction Best-practice as per JCTVS 2006 meta-analysis recommends following patients who undergo concomitant surgical Atrial Fibrillation (AF) ablation at 3-months, 1, 2 and 3 years to ensure AF resolution. A dedicated nurse-led arrythmia clinic managed these patients at Royal Sussex County Hospital (RSCH), Brighton but was relinquished. Follow-up was incorporated into routine cardiothoracic/cardiology clinics. This audit compares current practice at RSCH against best-practice (JCTVS). Method Patients who underwent surgical AF ablation between 2016-2017 at RSCH notes were interrogated for demographic, clinical and outcome data. Survival, freedom from AF at 3-years and post-operative anticoagulation/rate-control medications at follow-up data were extracted. Results Sixty-two patients underwent surgical AF ablation; 21 were followed up locally at RSCH and included in the final analysis. 53% had post-surgical AF resolution. At 3-years, 48% were free from AF; all patients survived. Only 38% patients had 4 follow-up appointments as per best-practice standards. 62% and 66% continued anticoagulation and rate-control medications, respectively. Conclusions Best-practice standards were poorly met. Patients inappropriately followed-up could incur severe AF-related complications including longer hospital stay, treatment and poorer quality of life. A nurse-led arrhythmia clinic can prevent AF-related hospital admissions and sequalae by ensuring cost-effective review, optimal anticoagulation, and rate/rhythm control. |
| Databáze: | OpenAIRE |
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