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Clin Res Cardiol. 2016 Jan;105(1):1-9. doi: 10.1007/s00392-015-0879-3. Epub 2015 Jun 24.

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

Author information

1
Section of Internal Medicine II, Department of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. thomas.pezawas@meduniwien.ac.at.
2
Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
3
Section of Internal Medicine II, Department of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.

Abstract

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.

KEYWORDS:

Ablation; Atrial fibrillation; Pulmonary vein isolation; Quality of life; Rhythm control

PMID:
26105951
DOI:
10.1007/s00392-015-0879-3
[Indexed for MEDLINE]

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