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Long-term quality of life after ablation of atrial fibrillation the impact of recurrence, symptom relief, and placebo effect.

Abstract：

OBJECTIVES:We sought to determine the relationship between atrial fibrillation (AF) ablation efficacy, quality of life (QoL), and AF-specific symptoms at 2 years. BACKGROUND:Although the primary goal of AF ablation is QoL improvement, this effect has yet to be demonstrated in the long term. METHODS:A total of 502 symptomatic AF ablation recipients were prospectively followed for recurrence, QoL, and AF symptoms. RESULTS:In 323 patients with 2 years of follow-up, 72% achieved AF elimination off antiarrhythmic drugs (AADs), 15% achieved AF control with AADs, and 13% had recurrent AF. The physical component summary scores of the Medical Outcomes Study Short Form 36 increased from 58.8 +/- 20.1 to 76.2 +/- 19.2 (p < 0.001) and the mental component summary scores of the Short Form 36 increased from 65.3 +/- 18.6 to 79.8 +/- 15.8 (p < 0.001). Post-ablation QoL improvements were noted across ablation outcomes, including recurrent AF (change in physical component summary: 12.1 +/- 19.7 and change in mental component summary: 9.7 +/- 17.9), with no significant differences in QoL improvement across 3 ablative efficacy outcomes. However, in 103 patients who completed additional assessment with Mayo AF Symptom Inventories (on a scale of 0 to 48), those with AF elimination off AADs had a change in AF symptom frequency score of -9.5 +/- 6.3, which was significantly higher than those with AF controlled with AADs (-5.6 +/- 3.8, p = 0.03) or those with recurrent AF (-3.4 +/- 8.4, p = 0.02). Independent predictors of limited QoL improvement included higher baseline QoL, obesity, and warfarin use at follow-up. CONCLUSIONS:AF ablation produces sustained QoL improvement at 2 years in patients with and without recurrence. AF-specific symptom assessment more accurately reflects ablative efficacy.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Wokhlu A,Monahan KH,Hodge DO,Asirvatham SJ,Friedman PA,Munger TM,Bradley DJ,Bluhm CM,Haroldson JM,Packer DL

doi

10.1016/j.jacc.2010.01.040

subject

Has Abstract

pub_date

2010-05-25 00:00:00

pages

2308-16

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(10)01084-3

journal_volume

pub_type

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Long-term quality of life after ablation of atrial fibrillation the impact of recurrence, symptom relief, and placebo effect.