A Prospective Randomized Multicenter Comparison on Health-Related Quality of Life: The Value of Add-On Arrhythmia Surgery in Patients with Paroxysmal, Permanent or Persistent Atrial Fibrillation Undergoing Valvular and/or Coronary Bypass Surgery

Henrica N. A. M. van Breugel*, F. H. M. Nieman, Ryan E. Accord, G. A. P. G. Van Mastrigt, Jan F. M. A. Nijs, J. L. Severens, Ries Vrakking, J. G. Maessen

*Corresponding author for this work

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Methods: 150 patients with documented atrial fibrillation were randomly assigned to undergo cardiac surgery with or without add-on surgery. Patients completed quality of life questionnaires, comprising the RAND 36-item Health Survey 1.0 (SF-36), Multidimensional Fatigue Inventory-20 (MFI-20) and EuroQoL (EQ-5D and VAS) at baseline and 3, 6, and 12 months following operation. Results: 132 patients completed the questionnaires at a minimum of one time-point during follow-up. At baseline patient characteristics, operative data and health-related quality of life were comparable. At 12-month follow-up 62 patients were free of atrial fibrillation without significant differences between groups (P = 0.28). Conversion to SR occurred in 69.8% (37/53) of patients with paroxysmal AF, in 28.2% (11/39) of patients with permanent AF and in 44.4% (12/27) of patients in persistent AF. Cardiac surgery in general resulted in an overall improvement of the RAND SF-36 and the MFI-20. However, the EQ-5D showed a significant deterioration in the subscale Pain/Discomfort for both groups (P <0.001), with a significant worse outcome for the control group (P = 0.006). Conclusions: Health-related quality of life in patients with paroxysmal, permanent and persistent atrial fibrillation improves after cardiac surgery regardless of giving add-on surgery or not, but this improvement is presumably more affected by treating the underlying heart disease than by restoring sinus rhythm. (J Cardiovasc Electrophysiol, Vol. 21, pp. 511-520, May 2010).
Original languageEnglish
Pages (from-to)511-520
JournalJournal of Cardiovascular Electrophysiology
Issue number5
Publication statusPublished - May 2010


  • atrial fibrillation
  • health-related quality of life
  • cardiac surgery
  • ablation
  • coronary bypass graft surgery

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