Clinical Significance of Patient Disease Awareness in Atrial Fibrillation: Risk Profiles and Post‐Ablation Outcomes

Background The clinical relevance of patient disease awareness on risk factor control and clinical outcomes after atrial fibrillation (AF) ablation remains incompletely understood. Methods We conducted a prospective cohort study enrolling 133 patients undergoing an initial AF ablation. Disease awareness was assessed using the Jessa Atrial Fibrillation Knowledge Questionnaire (JAKQ) —a 16‐item instrument comprising 8 questions on general AF knowledge and 8 questions on oral anticoagulant therapy—administered before and 1 year after ablation. We divided them into the poor disease awareness group and good disease awareness group according to the median value (75%) of the JAKQ score about AF in general and compared the baseline patient characteristics and the 1‐year changes in the JAKQ score, blood pressure, laboratory data, echocardiographic parameters, and AF/atrial tachycardia (AT) recurrence rate between the groups. Results Forty‐two (31.6%) patients were classified as having a poor disease awareness (< 75% of the JAKQ score about AF in general), which was associated with hypertension, diabetes, dyslipidemia, and greater left atrial volume (LAV). These trends in the poor disease awareness group remained unchanged 1 year after the ablation. During the 25.3 [15.7–34.9] month follow‐up, the AF/AT recurrence rate was significantly higher in the poor disease awareness than good disease awareness group (23.8% vs. 7.7%; p = 0.003 by the log‐rank test). Conclusions Poor disease awareness was linked to lifestyle‐related diseases, greater LAV before and even 1 year after the ablation, making it a potential surrogate marker for AF/AT recurrence. These findings highlight the clinical significance of disease awareness for AF.