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Impact of cardioversion strategy on functional capacity in patients with atrial fibrillation: the Assessment of Cardioversion Using Transesophageal Echocardiography (ACUTE) study.

Abstract：

BACKGROUND:The ACUTE Trial studied a transesophageal echocardiography (TEE)-guided strategy compared with a conventional strategy for management of patients with atrial fibrillation undergoing direct current cardioversion. The primary aim was to determine if patient functional capacity, measured by the Duke Activity Status Index (DASI), would differ between treatment strategies. METHODS:The DASI was self-administered at study enrollment and at 8-week follow-up in 1074 (88%) of 1222 total patients. Clinical outcomes associated with enrollment DASI scores and change in follow-up DASI scores were reviewed. RESULTS:There was no difference between the TEE-guided (n = 544) and conventional treatment (n = 530) groups for mean baseline and 8-week DASI scores, adjusting for baseline; however, patients who improved their DASI score were more likely to be in the TEE-guided group (P = .03). Pooled group data showed that the higher the enrollment DASI score, the more it tended to be positively related to maintenance of sinus rhythm (P = .06) at 8 weeks. The lower the enrollment DASI score, the more it was predictive of death (P = .03) and bleeding (P = .01) within 8 weeks. Patients with congestive heart failure (CHF) at enrollment showed greater improvement in DASI scores at 8 weeks compared with patients without CHF (DASI Delta 45.9% vs 31.6%, P < .001). CONCLUSIONS:There was no difference in DASI scores between treatment groups. However, TEE-guided treatment was a predictor of improved DASI at follow-up, and subgroup analysis showed that patients with CHF did show improvement in functional capacity with cardioversion.

journal_name

Am Heart J

journal_title

American heart journal

authors

Jasper SE,Lieber EA,Murray RD,Apperson-Hansen C,Black IW,Grimm RA,Pape LA,Klein AL,ACUTE Investigators.

doi

10.1016/j.ahj.2004.08.014

subject

Has Abstract

pub_date

2005-02-01 00:00:00

pages

309-15

issue

eissn

0002-8703

issn

1097-6744

pii

S0002870304005083

journal_volume

149

pub_type

杂志文章

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Impact of cardioversion strategy on functional capacity in patients with atrial fibrillation: the Assessment of Cardioversion Using Transesophageal Echocardiography (ACUTE) study.