Virk, Hafeez Ul Hassan

Cardiovascular disease (CVD) is the most common cause of death worldwide. Cardiac rehabilitation (CR) is increasingly recognised as an essential part of clinical care for patients with CVD. CR is a complex intervention that encompasses a multidisciplinary approach that focuses on health education, modification of cardiovascular risk factors, exercise training, physical activity and stress management. In the current American Heart Association/American College of Cardiology guidelines, cardiac rehabilitation is a class IA recommendation for secondary prevention of acute myocardial infarction, percutaneous coronary intervention and cardiac surgery and Class II recommendation for chronic stable heart failure. Despite proven effectiveness, however, participation in traditional CR remains low. Although the reasons for participation and non-participation in CR have been well described, the use of Twitter to explore public perceptions of CR has not yet been formally reported. To the best of our knowledge, the analysis of Twitter for insights on CR is a novel investigation that is relevant for addressing significant problems related to CR awareness in the digital age. We performed data mining of Twitter to assess patients’ perceptions regarding CR and the reasons for their participation and non-participation in CR between 23 July 2015 and 22 October 2017. We analysed a total of 5515 Twitter messages. Tweets associated with CR were often used to self-report on health status either before or after participating in CR or contained emotional language with positive or negative comments, advertisements or updated news. Twitter users wrote mainly positive comments about CR, suggesting the platform has the potential to disseminate both the benefits of CR and its research to the public on the worldwide scale.

IntroductionDofetilide is a class III antiarrhythmic prescribed to cardiovert persistent atrial fibrillation (AF) to sinus rhythm (SR).HypothesisTo determine the clinical predictors of cardioversion and readmission in persistent AF patients on dofetilide.MethodsWe analyzed 160 patients with persistent AF who were started on dofetilide and followed for 1 year. We examined age, sex, race, hypertension, diabetes, smoking, dyslipidemia, CAD, left ventricular ejection fraction (LVEF), creatinine, BMI and concomitant use of calcium channel blockers (CCB), β‐blockers in a multivariable logistic regression model. We also examined the same predictors in Cox regression model for AF‐related readmission within 1 year of follow‐up.Results13.5% individuals did not convert to SR on dofetilide. 55.6% converted on the first dose and 83.1% converted by the fourth dose. In multivariable logistic models, dyslipidemia (OR: 2.4, CI: 1.12‐5.16) and LVEF (OR: 3.83,CI: 1.37‐10.8) were associated with failure to convert with the first dose. Female sex and LVEF also were associated with increased risk of failure to convert at all. Concomitant use of CCB associated with decreased risk of failure to convert to SR. In Cox proportional model, female sex, age <63 years and CAD were associated with increased AF readmission within 1 year.ConclusionsDyslipidemia and LVEF <40% were associated with failure to cardiovert after first dose, and female sex and LVEF 40% were related to failure to convert at all on dofetilide in persistent AF patients. After 1‐year follow‐up, female sex, known CAD, and age <63 years were associated with increased AF readmissions.