Freedom from arrhythmia recurrence strongly predicted remarkable quality-of-life improvement following atrial fibrillation ablation (OR 2.42; 95% CI 1.27-4.59; P=0.007).
Cohort (n=956)
No
Does freedom from arrhythmia recurrence and lower AF burden predict quality of life improvement in patients undergoing catheter ablation for atrial fibrillation?
Following catheter ablation for atrial fibrillation, the vast majority of patients experience significant quality of life improvements, which are strongly predicted by freedom from arrhythmia recurrence and lower AF burden at 12 months.
Effect estimate: OR 2.42 (95% CI 1.27-4.59)
p-value: p=0.007
Background: Atrial fibrillation (AF) ablation targets improvement in quality of life (QoL). Data is scarce on predictors of QoL improvement following ablation. We aimed to investigate the clinical characteristics underlying differential response in QoL after AF ablation (with or without arrhythmia recurrence). Methods: All patients undergoing AF ablation (2013–2016) at our center were prospectively enrolled in a fully automated patient-reported outcomes registry. A large number of variables were collected including AF symptom severity scale and AF burden (as indicated by AF frequency and duration scores). Patients were divided into 3 groups based on self-report of QoL improvement: remarkable (super responders), mild/moderate, and unchanged or worse (nonresponders). Univariable and multivariable logistic regression models assessed clinical characteristics and QoL outcomes. Results: A total of 956 patients were included (25% females, mean age 63.9). Most patients (≈80%) were super responders (n=761), 138 (14.4%) had mild/moderate improvement, and 57 (5.9%) were nonresponders. The strongest predictors of remarkable QoL improvement were freedom of arrhythmia recurrence (OR, 2.42 95% CI, 1.27–4.59, P =0.007) and lower AF burden at 12 months. Similarly, higher AF burden was significantly associated with clinical nonresponse. In patients with observed clinical recurrence-QoL mismatch, changes in AF burden at 12 months were the main predictors of QoL outcome, with lower burden predicting higher improvement in QoL and vice versa. Conclusions: Most patients derive significant QoL benefit from AF ablation. Freedom from arrhythmia recurrence and lower AF burden predict remarkable QoL improvement following ablation.
Farwati et al. (Mon,) conducted a cohort in Atrial fibrillation (n=956). Catheter ablation was evaluated on Remarkable quality-of-life improvement (super responders) (OR 2.42, 95% CI 1.27-4.59, p=0.007). Freedom from arrhythmia recurrence strongly predicted remarkable quality-of-life improvement following atrial fibrillation ablation (OR 2.42; 95% CI 1.27-4.59; P=0.007).