Effect of catheter ablation on quality of life in patients with atrial fibrillation and its correlation with arrhythmia outcome

Raine, Daniel; Langley, Philip; Shepherd, Ewen; Lord, Stephen; Murray, Stephen; Murray, Alan; Bourke, John P

Abstract

Objective To assess the effect of catheter ablation on atrial fibrillation (AF) symptoms and quality of life (QoL). Methods Patients with AF scheduled for ablation were recruited. Pulmonary vein isolation (PVI) was performed and complex fractionated atrial electrogram (CFAE)±linear ablation undertaken in patients in AF despite PVI. QoL and AF symptoms were assessed using SF-36 V2 and Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaires before and 3 months after ablation. Change in QoL scores after ablation was correlated with clinical parameters and the extent of ablation. Magnitude of QoL change was compared between AFEQT and SF-36 physical component summary (PCS) and mental component summary (MCS) scores and correlated with arrhythmia outcome. Results 80 patients were studied. Summative and individual health scores for both AFEQT (51.5±22.0 vs 81.3±18.2; p<0.01) and SF-36 (PCS 43.3±10.5 vs 47.9±11.3; p<0.01 and MCS 45.0±11.5 vs 51.5±9.4; p<0.01) improved significantly in patients who maintained sinus rhythm after ablation, but not in those with recurrent AF. Improvement in AFEQT (25.4±19) was significantly greater than change in PCS (6.8±6.4; p<0.01) and MCS (8.5±7.9; p<0.01) scores and correlated more closely with arrhythmia outcome (AFEQT r=0.55; PCS r=0.26; MCS r=0.30). Conclusions Patients who maintained sinus rhythm after ablation had a significant improvement in AF symptoms and QoL; however, no improvement was observed in patients with recurrent AF. QoL change after ablation did not correlate with baseline clinical parameters or ablation strategy. AF specific QoL scales are more responsive to change and correlate better with ablation outcome.

Citation

Raine, D., Langley, P., Shepherd, E., Lord, S., Murray, S., Murray, A., & Bourke, J. P. (2015). Effect of catheter ablation on quality of life in patients with atrial fibrillation and its correlation with arrhythmia outcome. Open heart, 2(1), e000302. https://doi.org/10.1136/openhrt-2015-000302

• Journal Article Type: Article
• Acceptance Date: Jul 8, 2015
• Online Publication Date: Sep 10, 2015
• Publication Date: 2015-09
• Deposit Date: Oct 21, 2015
• Publicly Available Date: Nov 23, 2017
• Journal: Open heart
• Electronic ISSN: 2053-3624
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 2
• Issue: 1
• Pages: e000302
• DOI: https://doi.org/10.1136/openhrt-2015-000302
• Keywords: Catheter ablation; Atrial fibrillation
• Public URL: https://hull-repository.worktribe.com/output/379909
• Publisher URL: http://openheart.bmj.com/content/2/1/e000302.abstract
• Additional Information: Copy of article first published in: Open heart, 2015, v.2, issue 1.
• Contract Date: Nov 23, 2017