Health-related quality of life and atrial fibrillation burden are proposed as the optimal primary and complementary endpoints for atrial fibrillation ablation trials, replacing 30-second AF episodes.
The review advocates for shifting the primary endpoint in atrial fibrillation ablation trials from rhythm-related metrics to patient-reported outcomes like health-related quality of life.
The improvement of Patient-reported outcomes, such as health-related quality of life, is the main indication for atrial fibrillation ablation. Despite this guideline derived indication for an AF ablation procedure the current standardized primary endpoint in AF ablation trials is still rhythm-related, and primarily a 30-second long AF episode. The review presents reflections on the non-rational arguments of using rhythm related endpoints rather than Patient-reported outcomes in AF ablation procedure trials despite the mismatch between many of the rhythm related variables and symptoms. Arguments for health-related quality of life as the most optimal primary endpoint in clinical trials are presented while atrial fibrillation burden is presented as the most optimal electrical complementary endpoint, apart from being the major variable in mechanistic trials.
Blomström‐Lundqvist et al. (Tue,) conducted a review in Atrial fibrillation. Atrial fibrillation ablation trial endpoints was evaluated. Health-related quality of life and atrial fibrillation burden are proposed as the optimal primary and complementary endpoints for atrial fibrillation ablation trials, replacing 30-second AF episodes.