Key result
Early nurse practitioner follow-up post-ablation is linked to lower anxiety and fewer symptoms versus later physician care.
Why the study?
Professional society guidelines are conflicting and vague regarding the timing of follow-up care after AF ablation, and whether follow-up type and timing affect patient outcomes is unclear.
Does an early (1-week) follow-up visit by a nurse practitioner improve patient outcomes compared to a later (1 or 3 months) follow-up by a physician after atrial fibrillation ablation?
Observational (n=20)
Yes
Does an early (1-week) follow-up visit by a nurse practitioner improve patient outcomes compared to a later (1 or 3 months) follow-up by a physician after atrial fibrillation ablation?
Early follow-up by a nurse practitioner at 1 week post-atrial fibrillation ablation may improve patient-reported outcomes compared to delayed physician follow-up.
Early NP follow-up may improve anxiety and symptoms after AF ablation; hypothesis-generating and requires RCTs to confirm.
BACKGROUND: A multidisciplinary patient-centered approach using evidence-based care is recommended in recent atrial fibrillation (AF) guidelines to achieve quality patient outcomes. Professional society guidelines are conflicting and vague in recommendations on timing of follow-up after AF ablation. PURPOSE: The aim of this secondary analysis was to examine whether the type and timing of follow-up care after AF ablation affected patient outcomes. METHODS: A 2-year, longitudinal, pilot study to explore patient experiences during the first 6 months following an AF ablation was conducted. Patients completed surveys and phone interviews before ablation, and at 1, 3, and 6 months after the ablation. Pearson correlations and repeated-measures analysis of variance were used for comparison of outcomes over time. RESULTS: The sample (N = 20) had a mean age of 65 (± 7) years, was 55% female, 35% paroxysmal AF, and 65% persistent AF pre-ablation. Timing of follow-up visits following AF ablation varied widely. Patients reported many concerns and difficulties reflecting the lack of knowledge and unrealistic expectations of post-ablation recovery. Better outcomes were noted in those who were seen at 1-week post-ablation by a nurse practitioner (NP) compared with those who were not seen until 1 or 3 months after ablation by a physician. IMPLICATIONS FOR PRACTICE: Atrial fibrillation ablation is routinely performed in the United States, yet there seems to be a lack of standardization concerning the type and timing of follow-up care after AF ablation. These preliminary findings support a standardized approach to include an NP visit at one week after AF ablation to achieve quality AF patient outcomes.
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Wood et al. (2020) conducted an observational in Atrial fibrillation (post-ablation) (n=20). 1-week post-ablation nurse practitioner visit vs. Follow-up at 1 or 3 months by a physician was evaluated on Patient outcomes (anxiety, fatigue, number of symptoms) based on follow-up pattern. Patients seen by a nurse practitioner at 1-week post-ablation reported significantly lower anxiety, fewer symptoms, and improved ability to manage symptoms compared to those seen at 1 or 3 months by a physician.
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