Health-related quality of life changes in patients undergoing repeated catheter ablation for atrial fibrillation

• Published in: Clinical research in cardiology Vol. 105; no. 1; pp. 1 - 9
• Main Authors: Pezawas, Thomas, Ristl, Robin, Schukro, Christoph, Schmidinger, Herwig
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.01.2016; Springer Nature B.V
• Subjects: Academic Medical Centers; Aged; Atrial Fibrillation - physiopathology; Atrial Fibrillation - surgery; Cardiology; Catheter Ablation - methods; Cohort Studies; Electrocardiography; Female; Follow-Up Studies; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Original Paper; Pulmonary Veins - surgery; Quality of Life; Recurrence; Retrospective Studies; Treatment Outcome; Rhythm control; Ablation; Atrial fibrillation; Quality of life; Pulmonary vein isolation
• ISSN: 1861-0684; 1861-0692
• DOI: 10.1007/s00392-015-0879-3

Objective Pulmonary vein isolation (PVI) for paroxysmal or non-paroxysmal atrial fibrillation (AF) should increase health-related quality of life (QOL). Design Retrospective cohort study of consecutive patients scheduled for PVI. Setting University Medical Center. Main outcome measures QOL was assessed using the physical (PCS) and mental (MCS) component summary scores from the SF-12v2 in patients undergoing PVI (mean 50, range 0–100, with higher scores indicating greater QOL). SF-12v2 was obtained at initial presentation (3-months) before PVI and after PVI at the end of follow-up (mean 1.7 ± 1.4 years) which included: (1) Clinical status, ECG, and 24-h ECG every 3 months, (2) trans-telephonic ECGs for 4 weeks every 3 months, or (3) continuous ECG via implanted devices. A recurrence was any atrial arrhythmia >30 s. Results Out of 229 patients (73 % males; 58 ± 11 years), 72 % returned SF-12v2 regarding 187 PVI procedures: 56 % for 1st PVI, 48 % for 2nd PVI, 71 % for 3rd PVI, and 44 % for 4th PVI. The mean difference between before and after PVI was 10 for PCS and 9 for MCS. History of paroxysmal or non-paroxysmal AF did not influence QOL ( p  = 0.724). Patients with an estimated PCS improvement ≥10 or an estimated MCS improvement ≥9 had the best outcome after repeated PVI. Success rates were 72 or 82 % after 1 year compared to 20 and 22 % in patients not achieving this improvement, respectively ( p  < 0.0001). Conclusion Improvement in QOL correlates with success of AF ablation after single and repeated PVI. Assessment of QOL pre- and post-PVI can complement ECG techniques for PVI success monitoring.