Baseline and postprocedural health status outcomes in contemporary patients with atrial fibrillation who underwent catheter ablation: A report from the Japanese outpatient registry

Nobuhiro Ikemura, John A. Spertus, Takehiro Kimura, Yoshinori Katsumata, Taishi Fujisawa, Ikuko Ueda, Keiichi Fukuda, Seiji Takatsuki, Shun Kohsaka

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Randomized clinical trials have demonstrated that catheter ablation (CA) for atrial fibrillation improves health-related quality of life (HRQoL). In daily practice, however, CA is performed on a wide range of patients, and outcomes may vary. We aimed to examine baseline and 1-year HRQoL outcomes of patients with atrial fibrillation after CA in daily practice. METHODS AND RESULTS: Using a registry-based cohort study designed to recruit patients with atrial fibrillation newly referred to 11 hospitals, we extracted data from 1097 consecutive patients with atrial fibrillation who underwent CA between 2012 and 2019. The Atrial Fibrillation Effects on Quality of Life Overall Summary (AFEQT-OS) was assessed at registration and 1 year after, and a 5-point increase in AFEQT-OS score was considered a meaningful improvement. Overall, the median age was 64 (interquartile range, 56–70) years, 836 (76.2%) were men, and 93.0% (n=1021) of the patients answered the AFEQT questionnaire. The mean AFEQT-OS score was 74.9 (SD, 18.0) at registration and 88.8 (SD, 12.6) at 1 year after. Notably, the incidence of meaningful improvement in HRQoL after CA was 88.6% for the patients with impaired HRQoL (AFEQT-OS score <80), which was only 40.1% in those with preserved HRQoL (AFEQT-OS score ≥80). Female sex, left atrium diameter, and high baseline HRQoL were independently associated with nonimprovement after CA. CONCLUSIONS: The improvement in HRQoL after CA was similar to that seen in clinical trials; however, one-third of patients did not show improvement. These results underscore the importance of quantitative evaluation of patients’ HRQoL to maximize the effect of CA before its performance.

Original languageEnglish
Article numbere019983
JournalJournal of the American Heart Association
Volume10
Issue number18
DOIs
Publication statusPublished - 2021 Sep 21

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Gender differences
  • Patient-reported outcome
  • Quality of life

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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