Improvement of quality of life after ablation of longstanding persistent versus paroxysmal atrial fibrillation: results of 2-year follow-up
Authors:
V. Bulková 1,2; M. Fiala 3; L. Haman 4; J. Chovančík 3; L. Škňouřil 3; Š. Havránek 1; J. Pindor 3; J. Duda 4; J. Gorzolka 3; Kateřina Ivanová 2; P. Pařízek 4
Authors‘ workplace:
II. interní klinika kardiologie a angiologie 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Aleš Linhart, DrSc.
1; Ústav sociálního lékařství a zdravotní politiky Lékařské fakulty UP Olomouc, přednostka doc. PhDr. Kateřina Ivanová, Ph. D.
2; Oddělení kardiologie Nemocnice Podlesí, a. s., Třinec, přednosta prim. MUDr. Marian Branny
3; I. interní klinika Lékařské fakulty UK a FN Hradec Králové, přednosta prof. MUDr. Jan Vojáček, DrSc.
4
Published in:
Vnitř Lék 2011; 57(5): 456-462
Category:
Original Contributions
Overview
Aims:
The purpose of the study was to assess quality of life and socio-economic parameters in patients after ablation of paroxysmal versus longstanding persistent atrial fibrillation (AF).
Methods:
The study included 89 patients with paroxysmal AF and 56 patients with longstanding persistent AF who underwent ablation within 1 year, and were afterwards prospectively followed up for 2 years. Quality of life was evaluated by the EQ-5D questionnaire before and every 6 months after ablation.
Results:
Objective, respectively subjective quality of life at baseline was lower in patients with longstanding persistent AF (67 ± 16 vs 71 ± 10; p = 0.01, resp. 64 ± 12 vs 67 ± 16; p = 0.07); however, after 2 years, it exceeded that of the patients with paroxysmal AF (80 ± 17 vs 75 ± 18; p = 0.03; resp. 73 ± 13 vs 70 ± 17; p = 0.18). The baseline-2 year difference in improvement was higher in patients with longstanding persistent AF in both objective (p = 0,001) and subjective component (p = 0.05). Both groups displayed significant decrease in the days of hospitalization, and the days of working incapacity.
Conclusion:
Patients with longstanding persistent AF exhibit worse baseline quality of life than the patients with paroxysmal AF, and higher quality of life improvement after ablation.
Key words:
atrial fibrillation – paroxysmal atrial fibrillation – persistent atrial fibrillation – quality of life
Sources
1. Wokhlu A, Monahan KH, Hodge DO et al. Long-term quality of life after ablation of atrial fibrillation: the impact of recurrence, symptom relief, and placebo effect. J Am Coll Cardiol 2010; 55: 2309–2316.
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3. Wazni OM, Marrouche NF, Martin DO et al. Radiofrequency ablation vs. Antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial. JAMA 2005; 293: 2634–2640.
4. Jaïs P, Cauchemez B, Macle L et al. Catheter ablation versus antiarrhythmic drugs for atrial fibrillation: the A4 study. Circulation 2008; 118: 2498–2505.
5. Wilber DJ, Pappone C, Neuzil P et al. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: A randomized controlled trial. JAMA 2010; 303: 333–340.
6. Packer DL, Bardy GH, Worley SJ et al. Tachycardia-induced cardiomaopathy: a reversible form of left ventricular dysfunction. Am J Cardiol 1986; 57: 563–570.
7. Lévy S, Maarek M, Coumel P et al. Characterization of different subsets of atrial fibrillation in general practice in France: the ALFA study. The College of French Cardiologists. Circulation 1999; 99: 3028–3035.
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Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2011 Issue 5
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