Heartbeat: improved quality of life and reduced healthcare utilisation after catheter ablation in patients with drug-resistant paroxysmal atrial fibrillation

The role of catheter ablation of atrial fibrillation (AF) in management of patients with paroxysmal AF is controversial. In this issue of Heart , Gupta and colleagues1 report data from a multicentre study of 329 consecutive patients with drug-refractory paroxysmal AF treated with AF ablation by pulmonary vein isolation guided by a standardised CLOSE (contiguous optimised lesions) protocol. Patient reported quality of life (QOL) measures showed significant improvement across all domains at 12 months. In addition, QOL improvement was associated with a lower AF burden, measured by ambulatory monitoring. Overall, cardiovascular hospitalisations decreased by 42% after AF ablation. Patients with the lowest QOL measures at baseline had the most improvement after AF ablation (figure 1). Figure 1 Atrial fibrillation effect on quality of life survey (AFEQT) change versus baseline score. In the accompanying editorial, Elvan2 comments: ‘Significant reduction of the impact of AF on healthcare utilisation and improvement of QOL metrics should be regarded as important and patient-relevant healthcare values gained by catheter ablation of paroxysmal AF. Moreover, Gupta and colleagues1 report an inverse association between the extent of QOL improvement and residual AF burden post-ablation. These results emphasise the importance of incorporating AF-specific QOL …