Successful catheter ablation in asymptomatic longstanding persistent AF improved physical (P=0.032) and mental (P=0.041) quality of life scores, with 57% of patients remaining recurrence-free.
Cohort (n=61)
Does catheter ablation improve quality of life, exercise performance, and arrhythmia-free survival in patients with asymptomatic longstanding persistent atrial fibrillation?
Successful catheter ablation in asymptomatic longstanding persistent AF patients significantly improves quality of life and exercise performance.
BACKGROUND: Impact of catheter ablation on exercise performance, quality of life (QoL) and symptom perception in asymptomatic longstanding persistent AF (LSP-AF) patients has not been reported yet. METHODS AND RESULTS: Sixty-one consecutive patients (mean age 62 ±13 years, 71% males) with asymptomatic LSP-AF undergoing first catheter ablation were enrolled. Extended pulmonary vein antrum isolation plus ablation of complex fractionated atrial electrograms and nonpulmonary vein triggers was performed in all. QoL survey was taken at baseline and 12-months postablation, using Short Form-36 (SF-36). Information on arrhythmia perception was obtained using a standard questionnaire and corroborating symptoms with documented evidence of arrhythmia. Exercise tests were performed on 38 patients at baseline and 5 months after procedure. Recurrence was assessed using event recorder, cardiology evaluation, electrocardiogram, and 7-day holter monitoring. After 20 ± 5 months follow-up, 36 (57%) patients remained recurrence-free off-AAD. Of the 25 patients experiencing recurrence, 21 (84%) were symptomatic. Compared to baseline, follow-up SF-36 scores improved significantly in many measures. For patients with successful ablation, physical component summary (PCS) and mental component summary (MCS) demonstrated substantial improvement ( MCS: 64.2 ± 22.3 to 70.1 ± 18.6 P = 0.041; PCS: 62.6 ± 18.4 to 70.0 ± 14.4 P = 0.032). Postablation exercise study in recurrence-free patients showed significant reduction in resting and peak heart rate (75 ± 11 vs. 90 ± 17 and 132 ± 20 vs. 154.5 ± 36, respectively, P < 0.001), increase in peak oxygen pulse (13.4 ± 3 vs. 18.9 ± 16 mL/beat, Δ5.5 ± 15, P = 0.001), peak VO2 /kg (19.7 ± 5 to 23.4 ± 13 mL/kg/min Δ 3.7 ± 10, P = 0.043), and corresponding MET (5.6 ± 1 to 6.7 ± 4 Δ1.1 ± 3, P = 0.03). No improvement was observed in patients with failed procedures. CONCLUSION: Successful ablation improves exercise performance and QoL in asymptomatic LSP-AF patients.
Mohanty et al. (Thu,) conducted a cohort in Asymptomatic longstanding persistent atrial fibrillation (n=61). Catheter ablation was evaluated on Arrhythmia-free survival off antiarrhythmic drugs. Successful catheter ablation in asymptomatic longstanding persistent AF improved physical (P=0.032) and mental (P=0.041) quality of life scores, with 57% of patients remaining recurrence-free.
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