One-Stage Application of Mitral Valve Correction, Surgical Radiofrequency Ablation and Left Atrial Atrioplasty Objective: Our aim was to evaluate sinus rhythm restoration and its failure predictors after one-stage application of surgical radiofrequency ablation, left atrial reduction and mitral valve correction. Methods: This is a prospective longitudinal cohort study with historical controls. Patients were divided into 2 groups according to the performed type of operation-the main group included patients undergone one-stage mitral valve correction, surgical radiofrequency ablation and left atrial atrioplasty (n =47); and the control group consisted of patients undergone only mitral valve correction (n =76). Surgical radiofrequency ablation was performed under the scheme Maze-IV. Left atrial atrioplasty procedure was performed according to echocardiography data: if in women LA antero-posterior dimensions were more than 4.7 cm and in men more than 5.2 cm. Results: The study included 123 patients. In the main group (age of the patients 61.0±9.1 years, 55% male) sinus rhythm restoration was observed in 32 (68%) patients during the early postoperative period, but at the time of discharge it reduced to 19 (40%), but in 6 months it increased up to 37 (78%), and in 36 months sinus rhythm already was detected in 40 (85%) patients. At the same time, during the early postoperative period in the control group (patients aged 59.0±11.0 years, 61% male) only 31 (40%) of patients had sinus rhythm, in 6 months it was detected in 11 (14%) cases, and in 36 months sinus rhythm-only in 28 (37%) patients. Predictors of atrial fibrillation recurrence were revealed: valve disease continuance <4 years (p =0.017) and atrial fibrillation history <3 years (p =0.029). Conclusion: One-stage performing of mitral valve correction, surgical radiofrequency ablation and left atrial atrioplasty restores and maintains more regular sinus rhythm, even in presence of atrial fibrillation recurrence predictors.
Funding Acknowledgements Type of funding sources: None. Introduction COVID-19 worsens the prognosis in patients with cardiovascular diseases, including myocardial infarction (MI). In connection with this, cardiac rehabilitation (CR) programs must be adapted for this category of post-infarction patients. Little is known on effect of CR on quality of life and anxiety and depression in patients with MI and COVID-19. Objective The aim of the study was to evaluate the use of a modular CR program on quality of life, excercise tolerance, anxiety and depression in post-infarction patients recovered from COVID-19 infection during a pandemic. Methods Overall, 86 patients with previous COVID-19 infection were included in this prospective longitudinal study. We evaluated the parameters of quality of life according to the Seattle questionnaire, exercise tolerance according to the six-minute walk test, and the depression and anxiety rating scale (HADS) before and after applying the modular CR program. Results According to the computed tomography (CT) classification, the severity class of lung lesions was: grade CT1 -23%, CT2-48%, CT3-23% and CT4-6%. When assessing the quality of life before the start of the modular CR -74% complained of episodic attacks of angina pectoris, while at the end of the CR, only 5% of had chest pain (p<0.05). Tolerance to physical activity according to the 6-minute walk test improved significantly from 245 ± 3.6 meters before CR to 355 ± 5.1 meters in dynamics (p=0.012). The depression and anxiety reduced significantly (p=0.0023) after CR: before the onset of modular CR 55% of patients were depressed in and 69% exhibited anxiety; after CR, depression in 10.4% of patients had depression and 7% - anxiety. Conclusions The use of a modular CR program in postinfarction patients with COVID-19 improves the quality of life, exercise tolearnce and psychological status.
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