The illness perceptions of patients with percutaneous coronary intervention compared to patients with no percutaneous intervention, for acute myocardial infarction, in cardiac rehabilitation.

PURPOSE: Patients who receive percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) have been found to have low attendance at cardiac rehabilitation (CR). It has been suggested that this is because PCI patients have a benign perception of their coronary disease; however, this has never been quantitatively investigated. The aim of this prospective study was to evaluate the illness perceptions (IP) of patients with AMI treated with PCI. METHODS: The Heart Health Illness Perception Questionnaire (modified version of the Brief Illness Perception Questionnaire) and the Cardiac Beliefs Questionnaire were used to assess patients' IP and cardiac disease misconceptions, respectively. Patients in phase 2 of CR were recruited from the Royal Alexandria Hospital, Paisley, UK. One hundred two patients were identified from the cardiac unit database over a 16-week period and sent questionnaires. RESULTS: Fifty-six patients returned questionnaires suitable for analysis (54.9% response rate). There was a significant difference in the IP scores of the 3 groups [primary-PCI (pPCI) = 0.18 ±â€…1.44, elective-PCI = 5.27 ±â€…15.65, non-PCI = 9.94 ±â€…11.19; P = 0.046]. PCI patients had a significantly lower IP score than non-PCI patients (PCI = 1.62 ±â€…12.76, non-PCI = 9.94 ±â€…11.19; P = 0.027). pPCI patients had a significantly lower IP score than non-pPCI patients (pPCI = 0.18 ±â€…11.44, non-pPCI = 8.04 ±â€…13.11; P = 0.021). Of the PCI patients 22.9% agreed they were 'fixed for life' and a lower IP score was found to predict this opinion (P = 0.032). CONCLUSION: PCI patients, particularly pPCI patients, perceive their coronary disease to be relatively benign. Further research is required to investigate if this predicts poor attendance at CR.

Atrial fibrillation: an update on management.

Atrial fibrillation carries a markedly increased risk of stroke and left ventricular dysfunction, and is associated with reduced quality of life In light of the potential for poor outcomes and the likely understated presence of silent atrial fibrillation, opportunistic screening should be carried out in general practice Modifying the risk factors for atrial fibrillation is the cornerstone of management with adjuvant drug therapy to help maintain sinus rhythm, control the ventricular rate and reduce the risk of cerebral thromboembolism The need for anticoagulant therapy can be assessed by using the revised CHA2DS2-VASc score. Direct oral anticoagulants are now preferred to warfarin in those who qualify for their use Catheter ablation is an effective option to improve survival in patients with left ventricular dysfunction. It also improves quality of life and reduces arrhythmia-related hospital admissions