Higher baseline quality of life scores prior to first-time pulmonary vein isolation were associated with a lower likelihood of redo procedures within 1 year (OR 0.62 for Q4 vs Q1; P=0.001).
Cohort (n=3,336)
Yes
Does baseline quality of life predict the likelihood of redo pulmonary vein isolation in patients with atrial fibrillation?
Lower baseline quality of life in patients undergoing first-time pulmonary vein isolation for atrial fibrillation is associated with a higher likelihood of requiring a redo procedure within 1 year.
Effect estimate: OR 0.62
p-value: p=.001
Background Atrial fibrillation (AF) significantly impacts quality of life (QoL), necessitating effective therapeutic interventions such as pulmonary vein isolation (PVI). Although PVI's success is often measured by freedom from arrhythmia, clinical practice emphasizes symptom freedom and patient comfort, as captured by QoL tools such as the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire. Objective This study investigates the association between baseline QoL, changes in QoL, and redo PVI, aiming to align patient-centered outcomes with clinical decision-making. Methods Data from 3336 AF patients undergoing first-time PVI between 2018 and 2021 in Dutch heart centers were analyzed. Patients with baseline and 1-year follow-up QoL scores were categorized into quartiles based on pre-PVI AFEQT scores, and redo PVI rates were assessed within 1 year. Results Redo PVI was performed in 16.0% of patients within 1 year. Significant differences in left atrial volume index, left ventricular ejection fraction, and AF type were observed between redo and no-redo groups. Median AFEQT scores improved significantly: from 53.9 to 71.3 in redo patients and from 57.4 to 88.0 in others (P P =.52), 0.74 (Q3, P =.05), and 0.62 (Q4, P =.001) compared with Q1. Redo PVI rates varied significantly between heart centers, reflecting practice variation. Conclusion Lower baseline QoL is associated with a higher likelihood of redo PVI, emphasizing the role of patient-reported outcomes in AF management. Integrating QoL assessments into routine practice may support individualized care, create risk stratification, and contribute to standardizing clinical decision-making.
Kar et al. (2025) conducted a cohort in Atrial fibrillation (n=3,336). Baseline Quality of Life (AFEQT score) vs. Lower baseline QoL (Q1) was evaluated on Redo PVI within 1 year (OR 0.62, p=.001). Higher baseline quality of life scores prior to first-time pulmonary vein isolation were associated with a lower likelihood of redo procedures within 1 year (OR 0.62 for Q4 vs Q1; P=0.001).
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