TY - JOUR
T1 - Changes in quality of life, cognition and functional status following catheter ablation of atrial fibrillation
AU - Piccini, J.P.
AU - Todd, D.M.
AU - Massaro, T.
AU - Lougee, A.
AU - Haeusler, K.G.
AU - Blank, B.
AU - de Bono, J.P.
AU - Callans, D.J.
AU - Elvan, A.
AU - Fetsch, T.
AU - Van Gelder, I.
AU - Gentlesk, P.
AU - Grimaldi, M.
AU - Hansen, J.
AU - Hindricks, G.
AU - Al-Khalidi, H.
AU - Mont, L.
AU - Nielsen, J.C.
AU - Noelker, G.
AU - De Potter, T.
AU - Scherr, D.
AU - Schotten, U.
AU - Themistoclakis, S.
AU - Vijgen, J.
AU - Di Biase, L.
AU - Kirchhof, P.
N1 - Funding Information:
Funding AXAFA-AFNET 5 was an investigator initiated trial. The study was sponsored by the AF-NET. AXAFA-AFNET5 was partially funded by BMS/Pfizer and by the German Centre for Cardiovascular Research (DZHK) to AFNET. Further support came from European Union (grant agreement No 633196 (CATCH ME) to BB, PK, LM, US, AFNET), British Heart Foundation (FS/13/43/30324 and AA/18/2/34218 to PK), Leducq Foundation to PK and the Netherlands Heart Foundation (RACE V) to US.
Funding Information:
Competing interests The study was sponsored by the AF-NET with funding from BMS-Pfizer and the European Union. JPP receives grants for clinical research from Abbott, ARCA biopharma, Boston Scientific, Gilead, Janssen Pharmaceuticals and NHLBI and serves as a consultant to Abbott, Allergan, ARCA Biopharma, Bayer, Biotronik, GSK, Johnson & Johnson, Medtronic, Motif Bio, Sanofi and Phillips. DMT receives speaking honoraria from Boston Scientific, Medtronic and Abbott. KGH reports study grants by Bayer and Sanofi-Aventis, lecture fees/advisory board fees from Sanofi-Aventis, Pfizer, Bristol-Myers-Squibb, Boehringer Ingelheim, Daiichi Sankyo, Edwards Lifesciences, Biotronik and Medtronic. JV reports speaker honoraria from Abbott. PK receives research support for basic, translational and clinical research projects from European Union, British Heart Foundation, Leducq Foundation, Medical Research Council (UK) and German Centre for Cardiovascular Research, from several drug and device companies active in atrial fibrillation and has received honoraria from several such companies in the past. JCN is supported by a grant from the Novo Norvodisk Foundation (NNF16OC0018658). PK is listed as inventor on two patents held by University of Birmingham (Atrial Fibrillation Therapy WO 2015140571, Markers for Atrial Fibrillation WO 2016012783).
Publisher Copyright:
© 2020 BMJ Publishing Group. All rights reserved.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Objective To investigate changes in quality of life (QoL), cognition and functional status according to arrhythmia recurrence after atrial fibrillation (AF) ablation. Methods We compared QoL, cognition and functional status in patients with recurrent atrial tachycardia (AT)/AF versus those without recurrent AT/AF in the AXAFA-AFNET 5 clinical trial. We also sought to identify factors associated with improvement in QoL and functional status following AF ablation by overall change scores with and without analysis of covariance (ANCOVA). Results Among 518 patients who underwent AF ablation, 154 (29.7%) experienced recurrent AT/AF at 3 months. Patients with recurrent AT/AF had higher mean CHA 2 DS 2-VASc scores (2.8 vs 2.3, p<0.001) and more persistent forms of AF (51 vs 39%, p=0.012). Median changes in the SF-12 physical (3 (25th, 75th:-1, 8) vs 1 (-5, 8), p=0.026) and mental scores (2 (-3, 9) vs 0 (-4, 5), p=0.004), EQ-5D (0 (0,2) vs 0 (-0.1, 0.1), p=0.027) and Karnofsky functional status scores (10 (0, 10) vs 0 (0, 10), p=0.001) were more favourable in patients without recurrent AT/AF. In the overall cohort, the proportion with at least mild cognitive impairment (Montreal Cognitive Assessment <26) declined from 30.3% (n=157) at baseline to 21.8% (n=113) at follow-up. ANCOVA identified greater improvement in Karnofsky functional status (p<0.001) but not SF-12 physical (p=0.238) or mental scores (p=0.065) in those without recurrent AT/AF compared with patients with recurrent AT/AF. Conclusions Patients without recurrent AT/AF appear to experience greater improvement in functional status but similar QoL as those with recurrent AT/AF after AF ablation.
AB - Objective To investigate changes in quality of life (QoL), cognition and functional status according to arrhythmia recurrence after atrial fibrillation (AF) ablation. Methods We compared QoL, cognition and functional status in patients with recurrent atrial tachycardia (AT)/AF versus those without recurrent AT/AF in the AXAFA-AFNET 5 clinical trial. We also sought to identify factors associated with improvement in QoL and functional status following AF ablation by overall change scores with and without analysis of covariance (ANCOVA). Results Among 518 patients who underwent AF ablation, 154 (29.7%) experienced recurrent AT/AF at 3 months. Patients with recurrent AT/AF had higher mean CHA 2 DS 2-VASc scores (2.8 vs 2.3, p<0.001) and more persistent forms of AF (51 vs 39%, p=0.012). Median changes in the SF-12 physical (3 (25th, 75th:-1, 8) vs 1 (-5, 8), p=0.026) and mental scores (2 (-3, 9) vs 0 (-4, 5), p=0.004), EQ-5D (0 (0,2) vs 0 (-0.1, 0.1), p=0.027) and Karnofsky functional status scores (10 (0, 10) vs 0 (0, 10), p=0.001) were more favourable in patients without recurrent AT/AF. In the overall cohort, the proportion with at least mild cognitive impairment (Montreal Cognitive Assessment <26) declined from 30.3% (n=157) at baseline to 21.8% (n=113) at follow-up. ANCOVA identified greater improvement in Karnofsky functional status (p<0.001) but not SF-12 physical (p=0.238) or mental scores (p=0.065) in those without recurrent AT/AF compared with patients with recurrent AT/AF. Conclusions Patients without recurrent AT/AF appear to experience greater improvement in functional status but similar QoL as those with recurrent AT/AF after AF ablation.
KW - association
KW - atrial arrhythmia ablation procedures
KW - atrial fibrillation
KW - quality and outcomes of care
KW - ASSOCIATION
U2 - 10.1136/heartjnl-2020-316612
DO - 10.1136/heartjnl-2020-316612
M3 - Article
C2 - 33046527
SN - 1355-6037
VL - 106
SP - 1919
EP - 1926
JO - Heart
JF - Heart
IS - 24
ER -