Long-term health-related quality of life and rhythm outcomes of catheter ablation versus antiarrhythmic drugs in patients with atrial fibrillation.

Autor:	Svedung Wettervik V; Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Electronic address: victoria.svedung.wettervik@medsci.uu.se., Schwieler J; Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden., Bergfeldt L; Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden., Kennebäck G; Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden., Jensen S; Heart Centre, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden., Rubulis A; Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden., Sciaraffia E; Department of Medical Sciences, Uppsala University, Uppsala, Sweden., Blomström-Lundqvist C; Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Department of Cardiology, School of Medical Science, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Jazyk:	angličtina
Zdroj:	Heart rhythm [Heart Rhythm] 2024 Sep 21. Date of Electronic Publication: 2024 Sep 21.
DOI:	10.1016/j.hrthm.2024.09.044
Abstrakt:	Background: Data on long-term effects of catheter ablation vs antiarrhythmic drugs (AADs) on health-related quality of life (HRQoL) and atrial fibrillation (AF) burden are limited. Objective: The study aimed to assess long-term HRQoL and rhythm data in patients with symptomatic AF. Methods: The 75 patients who underwent ablation and 74 receiving AADs in the Catheter Ablation compared with Pharmacological Therapy for Atrial Fibrillation (CAPTAF) trial were followed for 48 months. The General Health subscale of the 36-Item Short-Form Health Survey, time to first AF episode ≥1 hour, and AF burden, recorded by implantable cardiac monitors, were compared. Results: One hundred forty-seven patients completed follow-up, with 7 crossovers in the ablation group and 34 crossovers in the AAD group. General Health improved by ablation from a median of 62 points at baseline to 79.2 points at follow-up (P < .001) and by AADfrom a median of 67 to 77 points (P < .001), without treatment differences (P = .77). Time to first AF episode ≥1 hour was longer (median 257 days in the ablation group vs 180 days in the AAD group; P = .025). The cumulative AF burden during follow-up was lower in the ablation group (median 0.3%; interquartile range [IQR] 0%-1.4%) than in the AAD group (1.6%; IQR 0.1%-11.0%); P = .01. The cumulative reduction in AF burden compared with baseline was greater in the ablation group (median -89.5%; IQR -98.4% to -51.3%) than in the AAD group (-52.7%; IQR -92.6% to 263.6%); P < .001. Conclusion: HRQoL improvement in long-term did not differ between ablation and AAD groups despite a larger reduction in AF burden after ablation. The results should be interpreted in the light of a high crossover rate in the AAD group. Competing Interests: Disclosures All authors have declared no conflicts of interest. (Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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