Key result
AF ablation in hemodialysis patients is linked to improved QoL and similar arrhythmia-free rates versus non-hemodialysis patients.
Why the study?
AF is the most common arrhythmia in hemodialysis patients, lowering quality of life and increasing dialysis-related complications, but the effect of AF ablation on quality of life in this population required evaluation.
Does catheter ablation of atrial fibrillation improve quality of life in patients undergoing hemodialysis?
Observational (n=1,072)
Does catheter ablation of atrial fibrillation improve quality of life in patients undergoing hemodialysis?
Catheter ablation for atrial fibrillation in hemodialysis patients significantly improves quality of life and intradialytic dyspnea, while demonstrating comparable efficacy and safety to ablation in non-hemodialysis patients.
May support ablation for QoL gains in hemodialysis AF; hypothesis-generating and leaves open need for RCTs.
BackgroundAtrial fibrillation (AF) is the most common arrhythmia in patients undergoing hemodialysis (HD); AF lowers quality of life (QoL) and increases the risk of dialysis-related complications. The present study aimed to evaluate the effectiveness of AF ablation on the QoL in patients undergoing HD.MethodsNineteen patients undergoing HD (14 men, age 68 ± 8 years; 15 with paroxysmal AF) who underwent catheter ablation (CA) of AF were enrolled in the study. The Kidney Disease Quality of Life Short Form (KDQOL-SF) was assessed to evaluate the QoL of the HD patients at baseline and 6 months after the ablation. Ablation outcomes and procedural complications were evaluated and compared to those of 1053 consecutive non-HD patients who underwent AF ablation.ResultsThe KDQOL-SF of the HD patients 6 months after the ablation showed an improvement in physical functioning (54 ± 23 to 68 ± 28, P < 0.01), general health perceptions (38 ± 17 to 48 ± 15, P < 0.01), and symptoms/problems (75 ± 21 to 84 ± 13, P = 0.02), compared to baseline. For intradialytic symptoms, dyspnea during HD significantly improved after the CA in the HD patients without AF recurrence (43% to 7%, P = 0.04), whereas the atrial tachyarrhythmias and hypotension during HD remained unchanged. During the follow-up period of 17 ± 13 months after the last procedure, the incidence of being arrhythmia-free was similar (HD patients, 79% vs non-HD patients, 86%, log-rank P = 0.82). No life-threatening complications occurred in any of the patients.ConclusionsCA of AF improves QoL in patients undergoing chronic HD therapy.
No takes yet. Share an insight, caveat, or question.
Hachisuka et al. (2022) conducted an observational in Atrial fibrillation in patients undergoing hemodialysis (n=1,072). Catheter ablation vs. Non-hemodialysis patients (for ablation outcomes) / Baseline (for QoL) was evaluated on Arrhythmia-free incidence (p=0.82). Catheter ablation for atrial fibrillation in hemodialysis patients improved quality of life and yielded a similar arrhythmia-free rate (79% vs 86%, P=0.82) to non-hemodialysis patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: