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Cardiac rehabilitation in atrial fibrillation patients with left atrial appendage occlusion: a randomized trial
Wu Y, Lin J, Gong B, Wang L, Ruan Z, Xu K
Journal of Cardiopulmonary Rehabilitation and Prevention 2022 Jul;42(4):266-271
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: Left atrial appendage (LAA) occlusion for atrial fibrillation (AF) is an invasive therapy that reduces stroke incidence and death. The impact of cardiac rehabilitation (CR) on patients with AF with LAA occlusion remains unknown. We aimed to evaluate the effects and safety of CR in patients with AF with LAA occlusion. METHODS: This 6-month single-center randomized controlled trial compared an exercise-based CR program with a control group. Patients with AF who underwent LAA occlusion from December 2018 to December 2020 were randomized into two groups: exercise-based CR and usual care (control). All patients underwent echocardiography, cardiac computed tomography, scale survey, physical function, and exercise capacity at baseline and at 3 and 6 mo follow-up. RESULTS: There were 33 and 30 patients in the control and CR groups, respectively, in the final analysis. After the study period, the 6-min walk test distance, handgrip and leg strength, and left ventricular ejection fraction increased significantly in the CR group compared with baseline. Significant between-group differences were found in the mental and physical component summary scales, including all eight subscales, of the Short Form 36. The incidence of incomplete endothelialization in the CR group at 3 and 6 months was significantly lower than that in the control group. CONCLUSIONS: Cardiac rehabilitation was shown to accelerate device endothelialization in patients with AF with LAA occlusion, while also improving the quality of life, exercise capacity, and physical function.
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