Changes in quality of life, cognition and functional status following catheter ablation of atrial fibrillation
Jonathan P. Piccini, Derick Todd, Tyler Massaro, Aimee Lougee, Karl Georg Hæusler, Benjamin Blank, Joseph de Bono, David J. Callans, Arif Elvan, Thomas Fetsch, Isabelle C. Van Gelder, Philip J. Gentlesk, Massimo Grimaldi, Jim Hansen, Gerhard Hindricks, Hussein R. Al‐Khalidi, Lluı́s Mont, Jens Cosedis Nielsen, Georg Noelker, Tom De Potter, Daniel Scherr, Ulrich Schotten, Sakis Themistoclakis, Johan Vijgen, Luigi Di Biase, Paulus Kirchhof
Abstract
OBJECTIVE: To investigate changes in quality of life (QoL), cognition and functional status according to arrhythmia recurrence after atrial fibrillation (AF) ablation. METHODS: We compared QoL, cognition and functional status in patients with recurrent atrial tachycardia (AT)/AF versus those without recurrent AT/AF in the AXAFA-AFNET 5 clinical trial. We also sought to identify factors associated with improvement in QoL and functional status following AF ablation by overall change scores with and without analysis of covariance (ANCOVA). RESULTS: -VASc scores (2.8 vs 2.3, p<0.001) and more persistent forms of AF (51 vs 39%, p=0.012). Median changes in the SF-12 physical (3 (25th, 75th: -1, 8) vs 1 (-5, 8), p=0.026) and mental scores (2 (-3, 9) vs 0 (-4, 5), p=0.004), EQ-5D (0 (0,2) vs 0 (-0.1, 0.1), p=0.027) and Karnofsky functional status scores (10 (0, 10) vs 0 (0, 10), p=0.001) were more favourable in patients without recurrent AT/AF. In the overall cohort, the proportion with at least mild cognitive impairment (Montreal Cognitive Assessment <26) declined from 30.3% (n=157) at baseline to 21.8% (n=113) at follow-up. ANCOVA identified greater improvement in Karnofsky functional status (p<0.001) but not SF-12 physical (p=0.238) or mental scores (p=0.065) in those without recurrent AT/AF compared with patients with recurrent AT/AF. CONCLUSIONS: Patients without recurrent AT/AF appear to experience greater improvement in functional status but similar QoL as those with recurrent AT/AF after AF ablation.