Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Quality Measures & Complications D-PO05 - Poster Session V (ID 39) Poster

D-PO05-127 - Patient Reported Outcomes And Quality Of Life In Patients With Or Without Arrhythmia Recurrence After Atrial Fibrillation Ablation (ID 559)

Abstract

Background: Atrial fibrillation (AF) ablation outcomes have traditionally focused on arrhythmia recurrence rates. Many patients may still derive clinical benefit despite arrhythmia recurrence due to reduction of either burden or AF related symptoms.
Objective: To assess improvement in quality of life (QOL) in patients with or without arrhythmia recurrence after ablation, using guideline recommended definitions.
Methods: An automated system for collection of patient reported outcomes (PRO) was implemented in a prospective cohort of AF ablation. We included all patients who participated (2013-2016) for a full year in PRO surveys. Patients assessed changes from baseline in QOL as: remarkable improvement, mild to moderate improvement, no change or worse. Outcomes were assessed after a single ablation.
Results: Of 956 patients (56% paroxysmal, 75% males, mean age 64), 792 (83%) remained arrhythmia free upon 1 year of follow up. Remarkable QOL improvement at 1 year by PRO was reported by 79.6% of patients, whereas 14.4% reported moderate to mild improvement. A minority of patients reported no change (4.5%) or worsening (1.5%) from baseline. The AF symptom severity score AFSSS decreased by a median of 7 points between baseline and 1 year (IQR 2-12). These findings were true for both paroxysmal and non-paroxysmal AF. Greater reduction in AFSSS was observed in patients who remained arrhythmia free (median reduction 7 vs 4 points, p=0.004). In categorical assessment of change in QOL, the degree of improvement also correlated with freedom from arrhythmia (p<0.0001): 85.9% of those with arrhythmia recurrence reported remarkable clinical improvement and 10.6% reported moderate or mild improvement. Importantly, among those with arrhythmia recurrence 49.4% reported remarkable improvement and 33.0% reported moderate or mild improvement. Only 4.9% of those with arrhythmia recurrence reported worsening QOL from baseline. Similar net benefits of ablation regardless of recurrence rates were observed for components of AFSSS, arrhythmia burden and healthcare utilization
Conclusion: Post AF ablation, a net clinical benefit in QOL and PRO was observed regardless of arrhythmia recurrence rates based on guideline recommended definitions of success and failure.
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