Assessment of the effect of catheter ablation on quality of life and predictors of improvement in patients with atrial fibrillation

Abstract

Introduction: Over the last decades the rate and rhythm control options available for patients with atrial fi brillation (AF) have been aimed at improving arrhythmia symptoms and quality of life (QoL). In terms of rhythm control catheter ablation has become a valid treatment option. Since it is an invasive and relatively costly procedure generally performed with the aim of symptom control, obtaining information on the degree to which QoL is affected by the intervention is of great importance. The aim of the present study was to assess the effect of pulmonary vein isolation (PVI) on the QoL of patients with AF and to determine the factors of greatest infl uence on the change in QoL. Material and methods: This was a multicenter prospective cohort study involving patients with atrial fi brillation who underwent radiofrequency PVI. Standardized questionnaires and scores were used to assess QoL before the procedure and at the end of the follow-up period. Results: The study included 131 patients at mean age of 59 ± 9.27 years, 75.6% (n=99) were men. The patients were followed for a mean of 39.7 ± 13.3 months. At the end of the follow-up period, we observed a signifi cant improvement (p < 0.001) in all domains of quality of life compared to baseline. Through multivariate regression analysis, left ventricular ejection fraction (p = 0.047), mitral regurgitation (p < 0.0001), body mass index (p = 0.002) and recurrences within the fi rst 3 months following PVI (p = 0.009) were found to be independent predictors of the change in QoL before and after ablation. Conclusion: Catheter ablation of atrial fi brillation results in improvement of QoL in patients with AF. Left ventricular ejection fraction, functional mitral regurgitation, body mass index and recurrences within the fi rst 3 months following PVI are important predictors of change in QoL after radiofrequency ablation. They are to be considered when choosing therapeutic strategy and defi ning the individual approach to each AF patient.

Keywords

• atrial fibrillation
• quality of life
• PVI
• catheter