Clinical Efficacy of Personalized Exercise Program and an Inhibitor of Fatty Acid β-oxidation in Rehabilitation of Patients With Atrial Fibrillation After Primary Radiofrequency Ablation of Pulmonary Venous Orifices
Overview
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- National Research Center for Preventive Medicine
- Enrollment
- 72
- Primary Endpoint
- Atrial Fibrillation Recurrence
Overview
Brief Summary
Atrial fibrillation (AF) is one of the most common forms of heart rhythm disorder in patients with cardiovascular diseases. The choice of treatment for AF is a complex problem, depending on the form (paroxysmal, persistent, permanent) of AF, clinical manifestations of cardiac arrhythmias, associated diseases, the effectiveness of antiarrhythmic drugs. The accumulated data to date indicate an efficacy of the method of radiofrequency ablation (RFA) in the treatment of the paroxysmal form of AF. The RFA procedure does not eliminate the pathological processes that take place during developed AF. This dictates the need to develop and test new technologies and physical rehabilitation programmes for patients. The positive clinical effects of physical rehabilitation programmes based on moderate-intensity exercises are well known. The search for drugs capable of improving the results of RFA for AF in patients becomes urgent. This creates the prerequisites for the study of the clinical efficacy of trimetazidine MV in the rehabilitation of patients with cardiac diseases who underwent treatment of AF with RFA, which will optimize the management of such patients in the inpatient and outpatient setting.
Detailed Description
The study is interventional (Clinical Trial), randomized in parallel groups. Enrollment: 72 participants.
The 72 male patients were randomized in 3 groups. In 1st group (control) patients were taken antiarrhythmical drugs and anticoagulants. They did only usual activity without walking. Patients in 2nd group were taken antiarrhythmical drugs and anticoagulants, participated in rehabilitation programme. Twice a week they came in clinical center to engage in physical training with an instructor. The programe was lasted for 6 months. Also patients did they usual physical activity, practiced walking. Patients in 3rd group were taken antiarrhythmical drugs and anticoagulants, selective inhibitor of fat acids oxidation for 6 months. They did only usual activity without walking.
The examination was carried for all 72 patients. Before RFA patients took blood tests, performed echocardiography, completed psychological questionnaires. After 3 days they took blood tests, performed 6-minute walk testing, ECG monitoring, completed psychological questionnaires. One month after RFA patient performed veloergometry testing. Three months after RFA the performed 6-minute walk testing, ECG monitoring, took blood tests, completed psychological questionnaires. Six months after RFA patients took blood tests, performed echocardiography, 6-minute walk testing, ECG monitoring, veloergometry testing, completed psychological questionnaires. Onward was a follow up period for 6 months. At the time point of 12 months patients took blood tests, performed echocardiography, ECG monitoring, veloergometry testing, completed psychological questionnaires.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- None
Eligibility Criteria
- Ages
- 30 Years to 70 Years (Adult, Older Adult)
- Sex
- Male
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •treated for atrial fibrillation with radiofrequency ablation
- •cardiac disease
- •providing written informed consent
Exclusion Criteria
- •Congenital and acquired heart defects.
- •Acute coronary syndrome (unstable angina, myocardial infarction), myocardial revascularization during the previous 6 months
- •Transient ischemic attack, stroke in history.
- •Arterial hypertension (BP ≥160/100 мм. рт. ст.)
- •The risk of thromboembolic complications on a scale CHA2DS2-VASc\> 2
- •Risk of hemorrhagic complications of anticoagulant therapy (HAS-BLED\> 3 points on the scale).
- •Complications after RFA.
- •Chronic heart failure above III FC (NYHA), ejection fraction (EF) \<40%.
- •Acute thrombophlebitis, complicated forms of varicose veins (thrombophlebitis, phlebothrombosis).
- •Pronounced atherosclerosis of peripheral arteries (intermittent claudication), requiring surgical intervention.
Arms & Interventions
Physical training
Integrated Rehabilitation consisting of exercise training (minimum 3 times a week for a total of 6 months)
Intervention: Physical training program (Other)
Trimetazidine
Treatment of trimetazidine in addition to standart therapy
Intervention: Trimetazidine (Drug)
Outcomes
Primary Outcomes
Atrial Fibrillation Recurrence
Time Frame: From 6 months to 12 months
Number of participants with recurrence of atrial fibrillation after RFA
Secondary Outcomes
No secondary outcomes reported