1 The impact of atrial fibrillation ablation on physical activity and quality of life. (16th October 2019)

• Record Type: Journal Article
• Authors: Glover, B; Hong, K
• Is Part Of: Heart. Volume 105(2019)Supplement 7
• Page Start: A1
• Page End: A1
• Publication Date: 2019-10-16
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2019-ICS.1
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with potentially life-threatening complications such as heart failure and a five-fold increase in the risk of ischemic stroke. AF can also result in disabling symptoms, which subsequently reduce an individual's quality of life (QoL) and exercise performance. The incidence and prevalence of AF continues to increase with the aging population, posing significant global healthcare concerns associated with AF-related hospitalizations, increased morbidity, and mortality. Catheter ablation (CA) is currently the mainstay of treatment for patients with symptomatic AF. However, there is limited evidence to correlate catheter ablation with improvements in exercise capacity and QoL outcomes. Methods: Thirty-six consecutive patients aged ≥18 years awaiting a first-time or re-do CA for symptomatic paroxysmal or persistent AF were enrolled. Patients were provided with a medical grade physical activity monitor which recorded and transmitted exercise performance over a 7-day period pre- and post-ablation. Exercise volume and intensity were determined by total step count and step rates thresholds for time spent performing moderate-to-vigorous physical activity (MVPA), respectively. At baseline and 3-months post-ablation, a 48-hour Holter monitor was performed and a QoL survey was administered using the Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaire. At 3-months, AF recurrence was recorded using Holter monitoring and the QoL assessment was repeated. A recurrence beyond the blanking period lasting >30 seconds was considered as a failure. Results: Of the 36 patients (mean age 60±10; 31% female), 30 (83%) were successful, while 6 (17%) had failed procedures. Overall, improvements in total step count (p=0.03) and MVPA (p=0.013) were observed in patients with successful procedures, while no such improvements were observed in the failure group. Additional improvements were also observed across echocardiographic and electrocardiographic parameters amongst patients with successful procedures. Significant improvements in left ventricular ejection fraction (LVEF) were demonstrated for patients without recurrent episodes of arrhythmia at 3-month follow-up (59±11% vs. 65±1%, Δ6.0±2.6; p=0.026). These results correlated to significantly higher global AFEQT scores amongst successful patients post-ablation (p=0.04). Conclusion: Amongst patients with symptomatic paroxysmal or persistent AF, successful treatment with CA led to significant improvements in exercise capacity and QoL. Further investigation is warranted to confirm these results in the long-term.