TY - JOUR
T1 - Symptom Under-Recognition of Atrial Fibrillation Patients in Consideration for Catheter Ablation
T2 - A Report From the KiCS-AF Registry
AU - Katsumata, Yoshinori
AU - Kohsaka, Shun
AU - Ikemura, Nobuhiro
AU - Ueda, Ikuko
AU - Hashimoto, Kenji
AU - Yamashita, Terumasa
AU - Miyama, Hiroshi
AU - Fujisawa, Taishi
AU - Kimura, Takehiro
AU - Tanimoto, Kojiro
AU - Momiyama, Yukihiko
AU - Suzuki, Masahiro
AU - Fukuda, Keiichi
AU - Takatsuki, Seiji
N1 - Funding Information:
This study was funded by the Grant-in-Aid for Scientific Research from the Japan Agency for Medical Research and Development (Pooled analysis for identifying RISK factors for Atrial Fibrillation and cardioembolic stroke, in Japanese: ID 924988), Japan Society for the Promotion of Science (Grant No. 20H03915, 16KK0186, and 16H05215), and by an unrestricted research grant from Bayer Yakuhin Ltd. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Publisher Copyright:
© 2021 American College of Cardiology Foundation
PY - 2021/5
Y1 - 2021/5
N2 - Objectives: This study sought to investigate whether symptom under-recognition is associated with the application of catheter ablation. Background: Atrial fibrillation (AF) symptom burden is frequently under-recognized and may affect the choice of treatment strategies. Methods: A total of 3,276 patients with AF consecutively registered in a Japanese multicenter database from 2012 to 2017 were analyzed. All patients underwent AF symptom burden assessment via the symptom and daily activities domain within the Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaire. For the present analysis, 1,173 symptomatic patients (AFEQT score ≤80) with a clinical indication for catheter ablation were included. Under-recognition of symptom burden was defined as no subjective complaints checked by physicians despite self-reported AFEQT scores ≤80. Logistic regression analysis identified the predictors associated with receiving catheter ablation. Results: Of the 1,173 patients (age: 68 ± 12 years, men: 61%) analyzed, 459 underwent catheter ablation (ablation group); they had lower overall AFEQT scores (p < 0.01 for all domains) compared with the nonablation group. At the 1-year follow-up, greater improvement in the AFEQT scores was noted in the ablation group, even after adjusting for clinically relevant factors (+20.0 ± 1.2, +14.2 ± 0.9, respectively; p < 0.001). Notably, 306 (28%) patients met the criteria for symptom under-recognition, which was associated with the nonuse of catheter ablation during follow-up (odds ratio: 0.41; 95% confidence interval: 0.28 to 0.60; p < 0.001). Conclusions: Under-recognition of AF symptom burden was frequently noted and was associated with less use of catheter ablation. Standardized recognition of symptoms using the application of validated questionnaires may facilitate outcome improvement.
AB - Objectives: This study sought to investigate whether symptom under-recognition is associated with the application of catheter ablation. Background: Atrial fibrillation (AF) symptom burden is frequently under-recognized and may affect the choice of treatment strategies. Methods: A total of 3,276 patients with AF consecutively registered in a Japanese multicenter database from 2012 to 2017 were analyzed. All patients underwent AF symptom burden assessment via the symptom and daily activities domain within the Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaire. For the present analysis, 1,173 symptomatic patients (AFEQT score ≤80) with a clinical indication for catheter ablation were included. Under-recognition of symptom burden was defined as no subjective complaints checked by physicians despite self-reported AFEQT scores ≤80. Logistic regression analysis identified the predictors associated with receiving catheter ablation. Results: Of the 1,173 patients (age: 68 ± 12 years, men: 61%) analyzed, 459 underwent catheter ablation (ablation group); they had lower overall AFEQT scores (p < 0.01 for all domains) compared with the nonablation group. At the 1-year follow-up, greater improvement in the AFEQT scores was noted in the ablation group, even after adjusting for clinically relevant factors (+20.0 ± 1.2, +14.2 ± 0.9, respectively; p < 0.001). Notably, 306 (28%) patients met the criteria for symptom under-recognition, which was associated with the nonuse of catheter ablation during follow-up (odds ratio: 0.41; 95% confidence interval: 0.28 to 0.60; p < 0.001). Conclusions: Under-recognition of AF symptom burden was frequently noted and was associated with less use of catheter ablation. Standardized recognition of symptoms using the application of validated questionnaires may facilitate outcome improvement.
KW - atrial fibrillation
KW - catheter ablation
KW - under-recognition
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U2 - 10.1016/j.jacep.2020.10.016
DO - 10.1016/j.jacep.2020.10.016
M3 - Article
C2 - 33358669
AN - SCOPUS:85099171089
SN - 2405-5018
VL - 7
SP - 565
EP - 574
JO - JACC: Clinical Electrophysiology
JF - JACC: Clinical Electrophysiology
IS - 5
ER -