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Amin M, Abdrakhmanov A, Kropotkin E, Traykov V, Salló Z, Gellér L, Lorgat F, Sapelnikov O, Toman O, Al-Muti K, Aljaabari M, Bystriansky A, Környei L, Mujović N, Simons S, Szegedi N. Ablation of Supraventricular Arrhythmias With as Low as Reasonably Achievable X-Ray exposure (AALARA): Results of Prospective, Observational, Multicenter, Multinational, Open-Label Registry Study on Real World Data Using Routine Ensite 3D Mapping During SVT Ablation. Pacing Clin Electrophysiol 2024. [PMID: 39331462 DOI: 10.1111/pace.15075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 08/15/2024] [Accepted: 09/04/2024] [Indexed: 09/28/2024]
Abstract
INTRODUCTION The reduction of fluoroscopic exposure during catheter ablation of supraventricular arrhythmias is widely adopted by experienced electrophysiology physicians with a relatively short learning curve and is becoming the standard of care in many parts of the world. While observational studies in the United States and some parts of Western Europe have evaluated the minimal fluoroscopic approach, there are scarce real-world data for this technique and the generalizability of outcomes in other economic regions. METHOD The AALARA study is a prospective, observational, multicenter, and multinational open-label study. Patients were recruited from 13 countries across Central Eastern Europe, North and South Africa, the Middle East, and the CIS (Commonwealth of Independent States), with different levels of operator expertise using minimal fluoroscopic exposure techniques. Data on radiation exposure, procedural success, complications, recurrence, and quality of life changes were collected and analyzed. RESULT A total of 680 patients were enrolled and followed for 6 months. The majority were ablation naïve with the commonest arrhythmia ablated being typical AVNRT (58%) followed by Atrial Flutter (23%). Zero fluoroscopy exposure was observed in almost 90% of the cases. Fluoroscopy was most commonly used during the ablation phase of the procedure. We observed a high acute success rate (99%), a low complication rate (0.4%), and a 6-month recurrence rate of 3.8%. There was a significant improvement in the patient's symptoms and quality of life as measured by patient global assessment. CONCLUSION The routine use of a 3D mapping system during right-sided ablation was associated with low radiation exposure and associated with high acute success rate, low complications, and recurrence rate along with significant improvement in quality of life. The data confirm the reproducibility of this approach in real-world settings across different healthcare systems, and operator experience supporting this approach to minimize radiation exposure without compromising efficacy and safety. TRIAL REGISTRATION NCT04716270.
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Affiliation(s)
- Mohammad Amin
- Department of Cardiac Electrophysiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, Bahrain
| | - Ayan Abdrakhmanov
- Department of Cardiology, National Research Cardiac Surgery Center, NPJSC, Nur-Sultan, Kazakhstan
| | - Evgeniy Kropotkin
- Department of Cardiology, Federal Center for Cardiovascular Surgery, Krasnoyarsk Region, Russian Federation
| | - Vasil Traykov
- Department of Cardiology, Acibadem City Clinic Tokuda Hospital, Sofia, Bulgaria
| | - Zoltán Salló
- Department of Cardiology, Semmelweis University Heart and Vascular Centre, Budapest, Hungary
| | - László Gellér
- Department of Cardiology, Semmelweis University Heart and Vascular Centre, Budapest, Hungary
| | - Faizel Lorgat
- Department of Cardiology, Christian Barnard Memorial Hospital, Cape Town, South Africa
| | - Oleg Sapelnikov
- Department of Cardiology, Institute of Clinical Cardiology, Moscow, Russian Federation
| | - Ondrej Toman
- Department of Cardiology, University Hospital Brno, Brno-Bohunice, Czech Republic
| | - Khalid Al-Muti
- Department of Cardiology, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Mohamed Aljaabari
- Department of Cardiology, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Adrian Bystriansky
- Department of Cardiology, Central Slovak Institute of Heart and Vascular Diseases, Banská Bystrica, Slovakia
| | - László Környei
- Department of Cardiology, Gottsegen György National Cardiovascular Institute, Budapest, Hungary
| | - Nebojša Mujović
- Department of Cardiology, University Clinical Centre of Serbia, Belgrade, Serbia
| | | | - Nándor Szegedi
- Department of Cardiology, Semmelweis University Heart and Vascular Centre, Budapest, Hungary
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Liu C, Li C, Xu X, Zhou M, Huang X, Zhou B, Cao J, Huang S, Guo Z. Wide QRS complex tachycardia with a mysterious mask-Tricuspid isthmus-dependent atrial flutter with preexcitation syndrome and dual atrioventricular nodal pathway conduction. Clin Case Rep 2023; 11:e8202. [PMID: 38028054 PMCID: PMC10645599 DOI: 10.1002/ccr3.8202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/29/2023] [Accepted: 10/28/2023] [Indexed: 12/01/2023] Open
Abstract
Key Clinical Message Atrial flutter (AFL) and supraventricular tachycardia (SVT) are common arrhythmias in clinic. However, some AFL cases may present additional complexities, such as both accessory pathways (AP) and dual atrioventricular node pathways, putting on a mysterious mask and making it challenging to distinguish on electrocardiograms (ECGs). Abstract A 60-year-old male patient had a sudden syncope, and an ECG showed wide QRS complex tachycardia. This diagnostic ambiguity is further compounded by the fact that SVT via AP conduction can exhibit wide QRS complex tachycardia characteristics resembling ventricular tachycardia (VT). Consequently, a definitive diagnosis through electrophysiological (EP) examination becomes imperative, as it dictates subsequent ablation strategies. In this article, we present a rare case involving three distinct arrhythmias including AFL, AP, and dual atrioventricular node pathways, and successfully treated through ablation.
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Affiliation(s)
- Chao Liu
- Department of CardiovasologyChanghai HospitalShanghaiChina
| | - Changjin Li
- Department of CardiovasologyChanghai HospitalShanghaiChina
| | - Xiaonan Xu
- Department of CardiovasologyChanghai HospitalShanghaiChina
| | - Mingyao Zhou
- Department of CardiovasologyChanghai HospitalShanghaiChina
| | - Xinmiao Huang
- Department of CardiovasologyChanghai HospitalShanghaiChina
| | - Bingyan Zhou
- Department of CardiovasologyChanghai HospitalShanghaiChina
| | - Jiang Cao
- Department of CardiovasologyChanghai HospitalShanghaiChina
| | - Songqun Huang
- Department of CardiovasologyChanghai HospitalShanghaiChina
| | - Zhifu Guo
- Department of CardiovasologyChanghai HospitalShanghaiChina
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Moons P, Norekvål TM, Arbelo E, Borregaard B, Casadei B, Cosyns B, Cowie MR, Fitzsimons D, Fraser AG, Jaarsma T, Kirchhof P, Mauri J, Mindham R, Sanders J, Schiele F, Torbica A, Zwisler AD. Placing patient-reported outcomes at the centre of cardiovascular clinical practice: implications for quality of care and management. Eur Heart J 2023; 44:3405-3422. [PMID: 37606064 DOI: 10.1093/eurheartj/ehad514] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 05/01/2023] [Accepted: 07/25/2023] [Indexed: 08/23/2023] Open
Abstract
Patient-reported outcomes (PROs) provide important insights into patients' own perspectives about their health and medical condition, and there is evidence that their use can lead to improvements in the quality of care and to better-informed clinical decisions. Their application in cardiovascular populations has grown over the past decades. This statement describes what PROs are, and it provides an inventory of disease-specific and domain-specific PROs that have been developed for cardiovascular populations. International standards and quality indices have been published, which can guide the selection of PROs for clinical practice and in clinical trials and research; patients as well as experts in psychometrics should be involved in choosing which are most appropriate. Collaborations are needed to define criteria for using PROs to guide regulatory decisions, and the utility of PROs for comparing and monitoring the quality of care and for allocating resources should be evaluated. New sources for recording PROs include wearable digital health devices, medical registries, and electronic health record. Advice is given for the optimal use of PROs in shared clinical decision-making in cardiovascular medicine, and concerning future directions for their wider application.
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Affiliation(s)
- Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35 PB7001, 3000 Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, Klipfontein Rd, Rondebosch, 7700 Cape Town, South Africa
| | - Tone M Norekvål
- Department of Heart Disease, Haukeland University Hospital, Haukelandsveien 22, 5009 Bergen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Jonas Lies veg, 875021 Bergen, Norway
| | - Elena Arbelo
- Cardiology Department, Hospital Clínic, Universitat de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain
- Institut d'Investigació August Pi i Sunyer (IDIBAPS). Rosselló 149-153, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Britt Borregaard
- Department of Cardiology, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19, 5000 Odense, Denmark
| | - Barbara Casadei
- Division of Cardiovascular Medicine, RDM, University of Oxford; Headley Way, Headington Oxford OX3 9DU, UK
- NIHR Biomedical Research Centre, Headley Way, Headington Oxford OX3 9DU, UK
| | - Bernard Cosyns
- Department of Cardiology, University Hospital Brussels, Laarbeeklaan 101, 1090 Jette, Belgium
| | - Martin R Cowie
- Royal Brompton Hospital & School of Cardiovascular Medicine, Faculty of Medicine & Lifesciences, King's College London, Sydney St, London SW3 6NP, UK
| | - Donna Fitzsimons
- School of Nursing & Midwifery, Queens University Belfast, 97 Lisburn Road, Belfast | BT9 7BL, Northern Ireland
| | - Alan G Fraser
- School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XW, UK
| | - Tiny Jaarsma
- Department of Medicine, Health and Caring Sciences, Linköping University, Campus Norrköping, 601 74 Norrköping, Sweden
- Nursing Science, Julius Center, University Medical Centre Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
| | - Paulus Kirchhof
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, D-20246 Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Martinistrasse 52, D-20246 Hamburg, Germany
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston Birmingham B15 2TT, UK
| | - Josepa Mauri
- Department of Cardiology, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916 Badalona, Barcelona, Spain
| | - Richard Mindham
- European Society of Cardiology (ESC) Patient Forum, 2035 route des colles, CS 80179 Biot, 06903 Sophia Antipolis Cedex, France
| | - Julie Sanders
- St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
- William Harvey Research Institute, Charterhouse Square, Queen Mary University of London, London EC1M 6BQ, UK
| | - Francois Schiele
- Department of Cardiology, University Hospital Besancon, 3 Bd Alexandre Fleming, 25030 Besançon, France
| | - Aleksandra Torbica
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Via Sarfatti, 10 20136 Milan, Italy
| | - Ann Dorthe Zwisler
- Department of Cardiology, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense, Denmark
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Vestergade 17, 5800 Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Campusvej 55, DK-5230 Odense, Denmark
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Szegedi N, Kroptkin E, Traykoc V, Abdrakhmanov A, Lorgat F, Sapelnikov O, Simons S, Amin M. Routine use of a 3D mapping system in the ablation of supraventricular arrhythmias with as low as reasonably achievable X-ray exposure (AALARA): protocol for a prospective, observational, multicentre, multinational, open-label registry study. BMJ Open 2023; 13:e072181. [PMID: 37541748 PMCID: PMC10407390 DOI: 10.1136/bmjopen-2023-072181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/18/2023] [Indexed: 08/06/2023] Open
Abstract
INTRODUCTION The reduction of fluoroscopic exposure during catheter ablation of supraventricular arrhythmias is widely adopted by experienced electrophysiology physicians with a relatively short learning curve and is becoming standard of care in many parts of the world. While observational studies in the USA and some parts of Western Europe have evaluated the minimal fluoroscopic approach, there are scarce real-world data for this technique and generalisability of outcome in other economic regions. METHODS AND ANALYSIS The arrhythmias with as low as reasonably achievable X-ray exposure study is a prospective, observational, multicentre and multinational open-label registry study. Up to 700 patients undergoing catheter ablation for right-sided supraventricular arrhythmias (according to national guidelines) will be enrolled for the routine use of the EnSite Precision 3D mapping system. Participating sites are distributed in 13 countries from Central Eastern Europe, North and South Africa, the Middle East and the CIS (Commonwealth of Independent States), with different levels of expertise using minimal fluoroscopic exposure techniques. After electrophysiological procedure, patients will be followed up for 6 months either in-clinic or via telephone interview. Patients will be asked to complete a study questionnaire at enrolment and 6 months after the invasive procedure to assess quality of life changes secondary to the procedure. The study's primary objective is to describe ionising radiation exposure during catheter ablation when the EnSite Precision 3D mapping system is used in supraventricular tachycardia ablation. The study's secondary objective is to assess the safety and efficacy of this method. Furthermore, fluoroscopy timing, total procedure time, success rate and complications will be reported. ETHICS AND DISSEMINATION The study was approved by the ethics committee at Mohammed Bin Khalifa Specialist Cardiac Centre (BDF/R&REC/2020-504) and the medical ethics committees of all participating sites. Participants will be required to provide informed consent before enrolment in the study. The study results will be published and presented at conferences. TRIAL REGISTRATION NUMBER NCT04716270.
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Affiliation(s)
- Nandor Szegedi
- Semmelweis University Heart and Vascular Centre, Budapest, Hungary
| | - Evgeniy Kroptkin
- Federal Center for Cardiovascular Surgery, Krasnoyarsk region, Russian Federation
| | - Vassil Traykoc
- Federal Center for Cardiovascular Surgery, Krasnoyarsk region, Russian Federation
| | | | - Faizel Lorgat
- Christian Barnard Memorial Hospital, Cape Town, South Africa
| | - Oleg Sapelnikov
- Institute of Clinical Cardiology, Moscow, Russian Federation
| | | | - Mohammad Amin
- Cardiology, Mohammed bin Khalifa bin Salman Al Khalifa Specialist Cardiac Centre, Awali, Bahrain
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Soulaidopoulos S, Brili S, Drakopoulou M, Sotiropoulos I, Archontakis S, Dilaveris P, Sideris S, Antoniou CK, Arsenos P, Skiadas I, Kordalis A, Doundoulakis I, Tsiachris D, Xydis P, Laina A, Oikonomou G, Tsioufis KP, Gatzoulis KA. Catheter ablation in grown-up congenital heart disease patients: A single-center experience. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2022. [DOI: 10.1016/j.ijcchd.2022.100326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Brugada J, Katritsis DG, Arbelo E, Arribas F, Bax JJ, Blomström-Lundqvist C, Calkins H, Corrado D, Deftereos SG, Diller GP, Gomez-Doblas JJ, Gorenek B, Grace A, Ho SY, Kaski JC, Kuck KH, Lambiase PD, Sacher F, Sarquella-Brugada G, Suwalski P, Zaza A. 2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J 2021; 41:655-720. [PMID: 31504425 DOI: 10.1093/eurheartj/ehz467] [Citation(s) in RCA: 522] [Impact Index Per Article: 174.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Breeman S, Constable L, Duncan A, Starr K, McDonald A, Wileman S, Cotton S. Verifying participant-reported clinical outcomes: challenges and implications. Trials 2020; 21:241. [PMID: 32131888 PMCID: PMC7057615 DOI: 10.1186/s13063-020-4169-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 02/13/2020] [Indexed: 11/10/2022] Open
Abstract
Background Researchers often rely on trial participants to self-report clinical outcomes (for example, fractures, re-operations). Little information exists as to the ‘accuracy’ of participant-reported clinical outcomes, particularly in randomised controlled trials (RCTs). To help address this evidence gap, we report four case studies, nested within different RCTs where participant-reported clinical outcome data were compared with those reported by clinicians or extracted from medical notes. Methods Four publicly-funded RCTs with different methods of verifying participant-reported outcomes were identified. In KAT, the participants were asked about hospital admissions for any reason. Where it was thought to be relevant to the trial knee, further information was sought from the lead surgeon at the admitting site to confirm whether or not the admission was relevant to the trial knee. In REFLUX, participants were asked about hospital admissions for any reason. For participants who reported a re-operation, further information was sought from the lead surgeon at the admitting site to confirm this. In RECORD, participants were asked three questions regarding broken bones. Where low-trauma fractures were reported, clinical verification was sought, initially from the research nurse at the site. In CATHETER, participants were asked about urinary tract infections (UTIs), and a prescription of antibiotics was provided for the treatment of UTIs following urethral catheterisation. The GPs of those who reported a UTI were contacted to confirm that an antibiotic prescription had been issued for the suspected UTI. Results In KAT, 397 of 6882 (6%) participant-reported hospital admissions were confirmed as relevant to the trial knee. In REFLUX, 16 of 19 participants (84%) who appeared to have had a re-operation were confirmed as having had one. In RECORD, 473 of 781 (61%) fractures reported by participants were confirmed as being low-trauma fractures. In CATHETER, 429 of 830 participant-reported UTIs (52%) were confirmed as such by the GPs. Conclusions We used different approaches in our verification of participant-reported outcomes in clinical trials, and we believe there is no one optimal solution. Consideration of issues such as what information is sought from participants, the phrasing of questions, whether the medical records are a true ‘gold standard’ and costs and benefits to the RCT may help determine the appropriate approach.
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Affiliation(s)
- Suzanne Breeman
- Centre for Healthcare Randomised Trials (CHaRT), Health Services Research Unit (HSRU), University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, Scotland
| | - Lynda Constable
- Centre for Healthcare Randomised Trials (CHaRT), Health Services Research Unit (HSRU), University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, Scotland.
| | - Anne Duncan
- Centre for Healthcare Randomised Trials (CHaRT), Health Services Research Unit (HSRU), University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, Scotland
| | - Kath Starr
- Centre for Healthcare Randomised Trials (CHaRT), Health Services Research Unit (HSRU), University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, Scotland
| | - Alison McDonald
- Centre for Healthcare Randomised Trials (CHaRT), Health Services Research Unit (HSRU), University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, Scotland
| | - Samantha Wileman
- Centre for Healthcare Randomised Trials (CHaRT), Health Services Research Unit (HSRU), University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, Scotland
| | - Seonaidh Cotton
- Centre for Healthcare Randomised Trials (CHaRT), Health Services Research Unit (HSRU), University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, Scotland
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Cardiff cardiac ablation patient-reported outcome measure (C-CAP): validation of a new questionnaire set for patients undergoing catheter ablation for cardiac arrhythmias in the UK. Qual Life Res 2015; 25:1571-83. [PMID: 26659900 PMCID: PMC4870294 DOI: 10.1007/s11136-015-1194-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2015] [Indexed: 11/24/2022]
Abstract
Purpose To formally test and validate a patient-reported outcome measure (PROM) for patients with cardiac arrhythmias undergoing catheter ablation procedures in the UK [Cardiff Cardiac Ablation PROM (C-CAP)]. Methods A multicentre, prospective, observational cohort study with consecutive patient enrolment from three UK sites was conducted. Patients were sent C-CAP questionnaires before and after an ablation procedure. Pre-ablation C-CAP1 (17 items) comprised four domains: patient expectations; condition and symptoms; restricted activity and healthcare visits; medication and general health. Post-ablation C-CAP2 (19 items) comprised five domains including change in symptoms and procedural complications. Both questionnaires also included the generic EQ-5D-5L tool (EuroQol). Reliability, validity, and responsiveness measures were calculated. Results A total of 517 valid pre-ablation and 434 post-ablation responses were received; questionnaires showed good feasibility and item acceptability. Internal consistency was good (Cronbach’s alpha >0.7) and test–retest reliability was acceptable for all scales. C-CAP scales showed high responsiveness (effect size >0.8). Patients improved significantly (p < 0.001) following ablation across all disease-specific and global scales. Minimal clinically important difference was calculated. Improvement beyond the smallest detectable change of 9 points (symptom severity scale), 3 points (frequency and duration of symptoms scale), and 8 points (impact on life scale) indicates an important change. Amendments to the C-CAP questionnaires were identified through the validation process and made to produce the final tools. Conclusions The final C-CAP questionnaires are valid, reliable, and responsive tools for measuring symptom change, impact, and expectations in patients undergoing ablation for cardiac arrhythmias. C-CAP questionnaires provide a tool with disease-specific and generic domains to explore how cardiac ablation procedures in the UK impact upon patients’ lives. Electronic supplementary material The online version of this article (doi:10.1007/s11136-015-1194-1) contains supplementary material, which is available to authorized users.
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Behar J, Behar J, Providência R, Cronbach P, Siddiqui S, Brough C, Ara F, Newham W, Ng F, Ayala-Paredes F, Withers K, Hayward C, Chin H, Fearn S, Omerod J, Gamble J, Foley P, Bostock J, Claridge S, Jackson T, Sohal M, Razavi R, Betts T, Herring N, Rinaldi C, Pourmorteza A, McVeigh E, Niederer S, Claridge S, Jackson T, Sohal M, Preston R, Carr-White G, Razavi R, Rajani R, Rinaldi C, Boveda S, Defaye P, Barra S, Babu G, Ang R, Algalarrondo V, Bouzeman A, Ahsan S, Deharo JC, Sporton S, Segal O, Klug D, Lambiase P, Sadoul N, Agarwal S, Piot O, Chow A, Périer M, Fauchier L, Babuty D, Lowe M, Leclercq C, Bordachar P, Marijon E, Wilson D, Panfilo D, Greenhut S, Stegemann B, Morgan J, Nicolson W, Li A, Behr E, Ng G, Raman G, Belchambers S, Rao A, Wright D, John I, Crockford C, Kaba R, Begg G, Tayebjee M, Leong K, Hu M, Kanapeckaite L, Roney C, Lim P, Harding S, Peters N, Varnava A, Kanagaratnam P, Roux JF, Badra M, White J, Lencioni M, Carolan-Rees G, Patrick H, Griffith M, Patel H, Spiesshoefer J, Morley-Smith A, Patel K, Rosen S, DiMario C, Lyon A, Cowie M. Devices & Sudden death. Europace 2015; 17:v10-v13. [PMCID: PMC4892105 DOI: 10.1093/europace/euv331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
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Withers KL, Wood KA, Carolan-Rees G, Patrick H, Lencioni M, Griffith M. Living on a knife edge-the daily struggle of coping with symptomatic cardiac arrhythmias. Health Qual Life Outcomes 2015; 13:86. [PMID: 26104746 PMCID: PMC4477616 DOI: 10.1186/s12955-015-0282-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 06/10/2015] [Indexed: 11/17/2022] Open
Abstract
Background In 2010 a retrospective audit was undertaken to assess the viability of using PROMs in patients with symptomatic cardiac arrhythmias having undergone percutaneous arrhythmia ablation. A response rate of 74 % was achieved, with finding suggesting that arrhythmia patients reported a significant impact on their work, social and family life. Aims To conduct a qualitative cross sectional survey to understand patients’ perspectives of how cardiac arrhythmias affect their daily lives, as part of a program to develop a Patient Reported Outcome Measure (PROM). Method Twenty five patients aged 18 or over, diagnosed with a variety of symptomatic cardiac arrhythmias referred for a cardiac ablation procedure took part in cognitive interviews. These aimed to inform the development of a patient reported outcome measure and to determine factors important to this patient group. Common themes were identified using content analysis. Results Participants reported that symptoms of their arrhythmia caused them considerable problems and impacted adversely on their quality of life in many ways. This extended through daily routine, work and social activities and also to friends and family, with fear and anxiety being significant factors for most responders. Patients felt their illness was poorly understood, even by health professionals, and often reported that they felt isolated, lacking support and information. Conclusion Symptomatic cardiac arrhythmias are a source of debilitating and life limiting symptoms, having a negative impact on quality of life. Symptoms and related complications are relevant across different arrhythmia substrates and patient groups. Trial registration The study is registered on the Clinical Trials website, Identifier NCT01672528
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Affiliation(s)
- Kathleen L Withers
- Cedar, Cardiff & Vale University Health Board, Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ, UK.
| | - Kathryn A Wood
- Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC, 27710, USA.
| | - Grace Carolan-Rees
- Cedar, Cardiff & Vale University Health Board, Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ, UK.
| | - Hannah Patrick
- National Institute for Health and Care Excellence, 10 Spring Gardens, London, SW1A 2BU, UK.
| | - Mauro Lencioni
- Cardiology Department, University Hospitals Birmingham NHS Foundation Trust, Edgebaston, Birmingham, B15 2GW, UK.
| | - Michael Griffith
- Cardiology Department, University Hospitals Birmingham NHS Foundation Trust, Edgebaston, Birmingham, B15 2GW, UK.
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Lane DA, Aguinaga L, Blomström-Lundqvist C, Boriani G, Dan GA, Hills MT, Hylek EM, LaHaye SA, Lip GYH, Lobban T, Mandrola J, McCabe PJ, Pedersen SS, Pisters R, Stewart S, Wood K, Potpara TS, Gorenek B, Conti JB, Keegan R, Power S, Hendriks J, Ritter P, Calkins H, Violi F, Hurwitz J. Cardiac tachyarrhythmias and patient values and preferences for their management: the European Heart Rhythm Association (EHRA) consensus document endorsed by the Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE). Europace 2015; 17:1747-69. [PMID: 26108807 DOI: 10.1093/europace/euv233] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Withers KL, Wood KA, Carolan-Rees G, Patrick H, Lencioni M, Griffith M. Establishing content validity in a novel patient reported outcome measure for cardiac arrhythmia ablation patients. Health Qual Life Outcomes 2015; 13:38. [PMID: 25884567 PMCID: PMC4520263 DOI: 10.1186/s12955-015-0233-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 03/10/2015] [Indexed: 11/29/2022] Open
Abstract
AIM Preliminary content validity testing of a UK Patient Reported Outcome Measure (PROM) for use in cardiac arrhythmia patients undergoing ablation treatment. METHODS Twenty five patients diagnosed with symptomatic cardiac arrhythmias participated in qualitative interviews to obtain their perspective of a draft PROM. As part of the process to establish preliminary content validity, patients were asked to complete the questionnaires and to identify missing and redundant items within the PROM, while also reviewing the instructions and formatting. The questionnaires were updated iteratively to reflect patient feedback. RESULTS Recurring themes were identified during qualitative interviews leading to improvements to the tool. Following modification of the PROM, based on patient feedback, subjects reported that the tool was fully inclusive and easy to comprehend. Patients found the instructions and layout of the tool acceptable and easy to use. CONCLUSION Qualitative patient interviews are an important part of PROM tool development. In the case of this cardiac ablation PROM, it enabled end users to assess the tool for inclusivity and accessibility, and to ensure that it addressed concerns important to the patient. Cognitive interviews were able to obtain patients' perspectives to establish face validity and content validity of the PROM. This is part of a process which will ensure that this disease-specific PROM measures cardiac arrhythmia patient symptoms and impact on patients' lives accurately and sensitively. The next study will use the PROM prospectively in over 450 arrhythmia patients to prospectively validate the tool. CONDENSED ABSTRACT Patients diagnosed with symptomatic cardiac arrhythmias provided feedback through cognitive interviews to facilitate improvements in a new disease specific PROM establishing preliminary face and content validity.
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Affiliation(s)
- Kathleen L Withers
- Cedar, Cardiff & Vale University Health Board, Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ, UK.
| | - Kathryn A Wood
- Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC, 27710, USA.
| | - Grace Carolan-Rees
- Cedar, Cardiff & Vale University Health Board, Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ, UK.
| | - Hannah Patrick
- National Institute for Health and Care Excellence, 10 Spring Gardens, London, SW1A 2BU, UK.
| | - Mauro Lencioni
- University Hospitals Birmingham NHS Foundation Trust, New Queen Elizabeth Hospital, Birmingham, B15 2GW, UK.
| | - Michael Griffith
- University Hospitals Birmingham NHS Foundation Trust, New Queen Elizabeth Hospital, Birmingham, B15 2GW, UK.
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Farkowski MM, Pytkowski M, Maciag A, Golicki D, Wood KA, Kowalik I, Kuteszko R, Szwed H. Gender-related differences in outcomes and resource utilization in patients undergoing radiofrequency ablation of supraventricular tachycardia: results from Patients' Perspective on Radiofrequency Catheter Ablation of AVRT and AVNRT Study. Europace 2014; 16:1821-7. [DOI: 10.1093/europace/euu130] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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