TY - JOUR
T1 - Association between quality of life and redo procedures after pulmonary vein isolation in atrial fibrillation patients
T2 - Data from the Netherlands Heart Registration
AU - van de Kar, Mileen R.D.
AU - van Steenbergen, Gijs J.
AU - Vermeer, Jasper R.
AU - van der Heijden, Jeroen F.
AU - Balt, Jippe F.
AU - Luermans, Justin G.L.M.
AU - Blaauw, Yuri
AU - Medendorp, Niki M.
AU - Veldman-Schulz, Daniela N.
AU - Dekker, Lukas R.C.
AU - van Veghel, Dennis
AU - Ablation Registration Committee of the Netherlands Heart Registration
N1 - Funding Information:
The data underlying this article were provided by the Netherlands Heart Registration with the permission of the participating hospitals. Data are available on reasonable request to the corresponding author and with permission of the Netherlands Heart Registration. The authors have no funding sources to disclose. None declared. All authors attest they meet the current ICMJE criteria for authorship. All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Mileen van de Kar, Gijs van Steenbergen and Niki Medendorp. The first draft of the manuscript was written by Mileen van de Kar and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Informed consent was waived as the study is retrospective in nature and uses anonymised data provided by the Netherlands Heart Registration. The study protocol was carried out in accordance with Declaration of Helsinki guidelines and was approved by the Institutional Review Board.
Publisher Copyright:
© 2025 Heart Rhythm Society
PY - 2025/6
Y1 - 2025/6
N2 - Background: Atrial fibrillation (AF) significantly impacts quality of life (QoL), necessitating effective therapeutic interventions such as pulmonary vein isolation (PVI). Although PVI's success is often measured by freedom from arrhythmia, clinical practice emphasizes symptom freedom and patient comfort, as captured by QoL tools such as the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire. Objective: This study investigates the association between baseline QoL, changes in QoL, and redo PVI, aiming to align patient-centered outcomes with clinical decision-making. Methods: Data from 3336 AF patients undergoing first-time PVI between 2018 and 2021 in Dutch heart centers were analyzed. Patients with baseline and 1-year follow-up QoL scores were categorized into quartiles based on pre-PVI AFEQT scores, and redo PVI rates were assessed within 1 year. Results: Redo PVI was performed in 16.0% of patients within 1 year. Significant differences in left atrial volume index, left ventricular ejection fraction, and AF type were observed between redo and no-redo groups. Median AFEQT scores improved significantly: from 53.9 to 71.3 in redo patients and from 57.4 to 88.0 in others (P <.001). Higher baseline QoL scores correlated with lower redo rates: odds ratios for redo PVI were 0.93 (Q2, P =.52), 0.74 (Q3, P =.05), and 0.62 (Q4, P =.001) compared with Q1. Redo PVI rates varied significantly between heart centers, reflecting practice variation. Conclusion: Lower baseline QoL is associated with a higher likelihood of redo PVI, emphasizing the role of patient-reported outcomes in AF management. Integrating QoL assessments into routine practice may support individualized care, create risk stratification, and contribute to standardizing clinical decision-making.
AB - Background: Atrial fibrillation (AF) significantly impacts quality of life (QoL), necessitating effective therapeutic interventions such as pulmonary vein isolation (PVI). Although PVI's success is often measured by freedom from arrhythmia, clinical practice emphasizes symptom freedom and patient comfort, as captured by QoL tools such as the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire. Objective: This study investigates the association between baseline QoL, changes in QoL, and redo PVI, aiming to align patient-centered outcomes with clinical decision-making. Methods: Data from 3336 AF patients undergoing first-time PVI between 2018 and 2021 in Dutch heart centers were analyzed. Patients with baseline and 1-year follow-up QoL scores were categorized into quartiles based on pre-PVI AFEQT scores, and redo PVI rates were assessed within 1 year. Results: Redo PVI was performed in 16.0% of patients within 1 year. Significant differences in left atrial volume index, left ventricular ejection fraction, and AF type were observed between redo and no-redo groups. Median AFEQT scores improved significantly: from 53.9 to 71.3 in redo patients and from 57.4 to 88.0 in others (P <.001). Higher baseline QoL scores correlated with lower redo rates: odds ratios for redo PVI were 0.93 (Q2, P =.52), 0.74 (Q3, P =.05), and 0.62 (Q4, P =.001) compared with Q1. Redo PVI rates varied significantly between heart centers, reflecting practice variation. Conclusion: Lower baseline QoL is associated with a higher likelihood of redo PVI, emphasizing the role of patient-reported outcomes in AF management. Integrating QoL assessments into routine practice may support individualized care, create risk stratification, and contribute to standardizing clinical decision-making.
KW - Atrial fibrillation
KW - Benchmarking
KW - Patient-centered care
KW - Pulmonary vein isolation
KW - Quality of life
KW - Real-world data
U2 - 10.1016/j.hroo.2025.03.017
DO - 10.1016/j.hroo.2025.03.017
M3 - Article
SN - 2666-5018
VL - 6
SP - 745
EP - 752
JO - Heart Rhythm O2
JF - Heart Rhythm O2
IS - 6
ER -