TY - JOUR
T1 - Baseline and postprocedural health status outcomes in contemporary patients with atrial fibrillation who underwent catheter ablation
T2 - A report from the Japanese outpatient registry
AU - Ikemura, Nobuhiro
AU - Spertus, John A.
AU - Kimura, Takehiro
AU - Katsumata, Yoshinori
AU - Fujisawa, Taishi
AU - Ueda, Ikuko
AU - Fukuda, Keiichi
AU - Takatsuki, Seiji
AU - Kohsaka, Shun
N1 - Funding Information:
This study was funded by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (grant nos. 20H03915, 16H05215, 16KK0186) and by an unrestricted research grant from Bayer Yakuhin, Ltd.
Funding Information:
Dr Kohsaka received an unrestricted research grant for the Department of Cardiology at Keio University School of Medicine from Bayer Pharmaceutical and Daiichi Sankyo; received grants from Bayer Yakuhin, Ltd. and Daiichi Sankyo; and received personal fees from Bristol-Myers Squibb. Dr Kimura received grants from Bayer Yakuhin, Ltd. Dr Spertus received personal fees from Novartis, AstraZeneca, Janssen, Bayer, Boehringer Ingelheim, Regeneron, Corvia, and United Healthcare; received grants from Bayer and Abbott Vascular; and owned equity in Health Outcomes Sciences. Dr Takatsuki received grants and personal fees from Bayer and received personal fees from Daiichi Sankyo and Bristol-Myers Squibb. The remaining authors have no disclosures to report.
Publisher Copyright:
© 2021, American Heart Association Inc.. All rights reserved.
PY - 2021/9/21
Y1 - 2021/9/21
N2 - 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.
AB - 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.
KW - Atrial fibrillation
KW - Catheter ablation
KW - Gender differences
KW - Patient-reported outcome
KW - Quality of life
UR - http://www.scopus.com/inward/record.url?scp=85116543646&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85116543646&partnerID=8YFLogxK
U2 - 10.1161/JAHA.120.019983
DO - 10.1161/JAHA.120.019983
M3 - Article
C2 - 34514817
AN - SCOPUS:85116543646
VL - 10
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 18
M1 - e019983
ER -