[Effectiveness of early proactive telephone follow-up on perioperative medication adherence in patients with atrial fibrillation].
Objective: To investigate the impact of adding an early proactive telephone follow-up (2-4 weeks post-ablation) to routine follow-up on perioperative medication adherence, incidence of clinical outcome events, and re-consultation in patients with atrial fibrillation undergoing catheter ablation. Methods: This study employed a prospective cohort design. The intervention group included 554 patients who underwent catheter ablation for atrial fibrillation at our hospital in January 2025, receiving an additional telephone follow-up within 2-4 weeks post-ablation. The control group included 910 patients who underwent catheter ablation at our hospital in February 2025, receiving only routine first outpatient follow-up at 3 months post-ablation. The telephone follow-up content included verifying comprehension of medical orders, guiding medication administration, answering questions, assessing postoperative recovery, identifying abnormal symptoms, providing medical advice, and offering psychological support. The primary outcome measure was medication adherence at 3 months post-ablation. Secondary outcome measures included the incidence of thromboembolic events, bleeding events, and re-consultation within 3 months post-ablation. All data were statistically analyzed using SPSS 26.0; P-values<0.05 indicated statistical significance. Results: Baseline characteristics were comparable between the two groups (all P-values>0.05). Regarding medication adherence at 3 months post-ablation, the proportion of patients regularly taking anticoagulants in the intervention group (56.50%) was significantly higher than that in the control group (44.07%) (χ2=21.30, P<0.001); the proportion of patients who self-discontinued medication in the intervention group (27.26%) was significantly lower than that in the control group (41.87%) (χ2=31.78, P<0.001). For the incidence of thromboembolic and bleeding events, no statistically significant differences were observed between the two groups (all P-values>0.05). Specifically, the incidence of thromboembolic events was 1.08% (n=6) in the intervention group and 1.65% (n=15) in the control group (χ2=0.77, P=0.379); the incidence of bleeding events was 0.18% (n=1) and 0.22% (n=2), respectively (χ2=0.19, P=0.664). The overall incidence of any thromboembolic or bleeding event was 1.26% (n=7) and 1.76% (n=16), respectively, and this difference was not statistically significant (χ2=0.54, P=0.460). Regarding re-consultation, the incidence of outpatient visits due to cardiovascular disease was significantly lower in the intervention group (2.53%, n=14) than in the control group (6.81%, n=62) (χ2=12.84, P<0.001). No statistically significant differences were observed between the two groups for emergency visits due to cardiovascular disease (χ2<0.01,P=0.975), hospitalization due to cardiovascular disease (χ2<0.01,P=0.985), or re-consultation/hospitalization for any reason (χ2=0.95, P=0.329). Conclusion: Early proactive telephone follow-up can significantly improve perioperative medication adherence in patients with atrial fibrillation undergoing catheter ablation and effectively reduce postoperative outpatient visits. This simple and feasible intervention has positive clinical application value for improving short-term patient outcomes and optimizing medical resource allocation.