Impact of COVID-19 on patients awaiting ablation for atrial fibrillation. Issue 1 (13th June 2022)

• Record Type: Journal Article
• Authors: Pius, Charlene; Ahmad, Hasan; Snowdon, Richard; Ashrafi, Reza; Waktare, Johan EP; Borbas, Zoltan; Luther, Vishal; Mahida, Saagar; Modi, Simon; Hall, Mark; Gupta, Dhiraj; Todd, Derick
• Is Part Of: Open heart. Volume 9:Issue 1(2022)
• Publication Date: 2022-06-13
• Subjects: atrial fibrillation -- COVID-19 -- catheter ablation -- delivery of health care; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Patients -- Periodicals; 616.12005
• DOI: 10.1136/openhrt-2022-001969
• Languages: English
• ISSNs: 2398-595X

Abstract

Abstract : Objective: Atrial fibrillation (AF) ablation services were significantly affected by the COVID-19 pandemic. We aimed to evaluate a symptom-based clinician prioritisation scheme for waiting list management compared with patient-completed quality of life (QoL) scores. We also sought to understand factors influencing QoL, particularly the impact of COVID-19, on patients awaiting AF ablation, via a bespoke questionnaire. Methods: Patients awaiting AF ablation were sent two QoL questionnaires (Atrial Fibrillation Effect on QualiTy of Life (AFEQT) and EuroQol 5D (EQ5D-5L)) and the bespoke questionnaire. At a separate time point, patients were categorised as C1—urgent, C2—priority or C3—routine by their cardiologist based on review of clinic letters. Results: There were 118 patients included with priority categorisation available for 86 patients. Median AFEQT scores were lower in C2 (30.4; 17.2–51.9) vs C3 patients (56.5; 32.1–74.1; p<0.01). Unplanned admission occurred in 3 patients in C3 with AFEQT scores of <40. Although 65 patients had AF symptoms during the pandemic, 43.1% did not seek help where they ordinarily would have. An exercise frequency of ≥3–4 times a week was associated with higher AFEQT (56.5; 41.2–74.1; p<0.001) and EQ5D (0.84; 0.74–0.88; p<0.0001) scores. Conclusion: The QoL of patients awaiting AF ablation is impaired and AFEQT helps to identify patients at risk of admission, over and above physician assessment. COVID-19 influenced patients seeking medical attention with symptomatic AF when they normally would. Regular exercise is associated with better QoL in patients awaiting AF ablation.