A Comparative Analysis of the Effects of Cardioversion and Ablation on Anxiety, Sleep, and Quality of Life in Patients Diagnosed With Atrial Fibrillation

BACKGROUND AND AIMS: This study aims to evaluate changes in quality of life, anxiety levels, and sleep quality before and after elective electrical cardioversion or ablation in patients diagnosed with chronic atrial fibrillation (AF). METHODS: This is a single-center, quasi-experimental study with a two-group, pretest-posttest design conducted between January and December 2024 in a training and research hospital in Istanbul. A total of 57 patients who underwent either cardioversion (n = 30) or ablation (n = 27) were included. Data were collected using the AFEQT Quality of Life Questionnaire, Beck Anxiety Inventory, and Pittsburgh Sleep Quality Index, and analyzed with R software. Statistical analyses included Student's t-test, Pearson's Chi-square, Fisher's exact test, paired two-sample t-test, and Welch's unequal variance t-test. A p value of < 0.05 was considered significant. RESULTS: Post-treatment quality of life significantly improved in both groups (AFEQT: ablation +21, cardioversion +11 points). Anxiety levels decreased in the ablation group (-4.7 points), while sleep quality showed no significant change (p = 0.092). In the cardioversion group, significant improvements were observed in both anxiety and sleep quality (BAI -8.63; PSQI -1.10; p < 0.001). Regression analyses showed significant correlations between quality of life, anxiety, and sleep both before and after treatment. CONCLUSION: Improvements in quality of life were observed following both ablation and cardioversion procedures in patients with AF. Greater reductions in anxiety and sleep disturbance scores were observed in the cardioversion group compared with the ablation group.