TY - JOUR
T1 - Changes in quality of life, cognition and functional status following catheter ablation of atrial fibrillation
AU - Piccini, Jonathan P
AU - Todd, Derick M
AU - Massaro, Tyler
AU - Lougee, Aimee
AU - Haeusler, Karl Georg
AU - Blank, Benjamin
AU - De Bono, Joseph Paul
AU - Callans, David J
AU - Elvan, Arif
AU - Fetsch, Thomas
AU - Van Gelder, Isabelle
AU - Gentlesk, Philip
AU - Grimaldi, Massimo
AU - Hansen, Jim
AU - Hindricks, Gerhard
AU - Al-khalidi, Hussein
AU - Mont, Lluis
AU - Nielsen, Jens Cosedis
AU - Noelker, Georg
AU - De Potter, Tom
AU - Scherr, Daniel
AU - Schotten, Ulrich
AU - Themistoclakis, Sakis
AU - Vijgen, Johan
AU - Di Biase, Luigi
AU - Kirchhof, Paulus
PY - 2020/10/12
Y1 - 2020/10/12
N2 - Objective To investigate changes in quality of life (QoL), cognition and functional status according to arrhythmia recurrence after atrial fibrillation (AF) ablation.
Methods We compared QoL, cognition and functional status in patients with recurrent atrial tachycardia (AT)/AF versus those without recurrent AT/AF in the AXAFA–AFNET 5 clinical trial. We also sought to identify factors associated with improvement in QoL and functional status following AF ablation by overall change scores with and without analysis of covariance (ANCOVA).
Results Among 518 patients who underwent AF ablation, 154 (29.7%) experienced recurrent AT/AF at 3 months. Patients with recurrent AT/AF had higher mean CHA2DS2-VASc scores (2.8 vs 2.3, p<0.001) and more persistent forms of AF (51 vs 39%, p=0.012). Median changes in the SF-12 physical (3 (25th, 75th: −1, 8) vs 1 (−5, 8), p=0.026) and mental scores (2 (−3, 9) vs 0 (−4, 5), p=0.004), EQ-5D (0 (0,2) vs 0 (−0.1, 0.1), p=0.027) and Karnofsky functional status scores (10 (0, 10) vs 0 (0, 10), p=0.001) were more favourable in patients without recurrent AT/AF. In the overall cohort, the proportion with at least mild cognitive impairment (Montreal Cognitive Assessment <26) declined from 30.3% (n=157) at baseline to 21.8% (n=113) at follow-up. ANCOVA identified greater improvement in Karnofsky functional status (p<0.001) but not SF-12 physical (p=0.238) or mental scores (p=0.065) in those without recurrent AT/AF compared with patients with recurrent AT/AF.
Conclusions Patients without recurrent AT/AF appear to experience greater improvement in functional status but similar QoL as those with recurrent AT/AF after AF ablation.
AB - Objective To investigate changes in quality of life (QoL), cognition and functional status according to arrhythmia recurrence after atrial fibrillation (AF) ablation.
Methods We compared QoL, cognition and functional status in patients with recurrent atrial tachycardia (AT)/AF versus those without recurrent AT/AF in the AXAFA–AFNET 5 clinical trial. We also sought to identify factors associated with improvement in QoL and functional status following AF ablation by overall change scores with and without analysis of covariance (ANCOVA).
Results Among 518 patients who underwent AF ablation, 154 (29.7%) experienced recurrent AT/AF at 3 months. Patients with recurrent AT/AF had higher mean CHA2DS2-VASc scores (2.8 vs 2.3, p<0.001) and more persistent forms of AF (51 vs 39%, p=0.012). Median changes in the SF-12 physical (3 (25th, 75th: −1, 8) vs 1 (−5, 8), p=0.026) and mental scores (2 (−3, 9) vs 0 (−4, 5), p=0.004), EQ-5D (0 (0,2) vs 0 (−0.1, 0.1), p=0.027) and Karnofsky functional status scores (10 (0, 10) vs 0 (0, 10), p=0.001) were more favourable in patients without recurrent AT/AF. In the overall cohort, the proportion with at least mild cognitive impairment (Montreal Cognitive Assessment <26) declined from 30.3% (n=157) at baseline to 21.8% (n=113) at follow-up. ANCOVA identified greater improvement in Karnofsky functional status (p<0.001) but not SF-12 physical (p=0.238) or mental scores (p=0.065) in those without recurrent AT/AF compared with patients with recurrent AT/AF.
Conclusions Patients without recurrent AT/AF appear to experience greater improvement in functional status but similar QoL as those with recurrent AT/AF after AF ablation.
KW - atrial arrhythmia ablation procedures
KW - atrial fibrillation
KW - quality and outcomes of care
UR - http://www.scopus.com/inward/record.url?scp=85094652573&partnerID=8YFLogxK
U2 - 10.1136/heartjnl-2020-316612
DO - 10.1136/heartjnl-2020-316612
M3 - Article
SN - 1355-6037
VL - 106
SP - 1919
EP - 1926
JO - Heart
JF - Heart
IS - 24
ER -