Abstract P302: Improvement of Quality of Life and Socioeconomic Parameters After Ablation is Equal in Patients With Paroxysmal and Persistent Atrial Fibrillation

Background: Because patients with persistent atrial fibrillation (AF) are perceived to have more ‘stable’ symptoms, it is unclear if their long-term resource use and health status improves after treatment with radiofrequency catheter ablation (RFA). Methods: In a large, multicentre-study, prospective cohort of 472 consecutive patients undergoing RFA, we examined the success rate, resource use, and quality of life (QoL) of patients with paroxysmal and persistent AF at baseline and 18 months after RFA. QoL was assessed using the EQ-5D questionnaire. Results: The mean age of the study cohort was 57+9 years, of which 126 (27%) were female. Of 472 patients, 314 patients (66.5%; mean age 57+10 years) had paroxysmal AF and 158 (33.5%; mean age 58+9 years) had persistent AF. Patients with paroxsymal AF reported more frequent acute symptoms (palpitations [82 vs. 43%; P<0.001], chest discomfort [16 vs. 8%, P<0.001], syncope [8 vs. 2% P<0.001] and presyncope [14 vs. 5%; P=<0.001], while patients with persistent AF reported more frequent chronic symptoms (incapacity [44% vs. 78%; p<0.001], dyspnea [52% vs. 81%; P<0.001] and fatigue [53 vs. 62%; P=0.6]). Compared to their baseline, patients with paroxysmal AF at the 18-month follow-up reported fewer days in the hospital per year (2.6 vs. 0.7; P<0.001), days off from work per year (9.6 vs. 1.5; P<0.001), and need for repeat cardioversions per patient (0.4 vs. 0.2; P=0.01), as well as improved subjective QoL (67% vs. 76%; P<0.001) and objective QoL (71% vs. 79%; P<0.001). Similarly, compared to their baseline, patients with persistent AF at the 18-month follow-up reported fewer days in the hospital per year (1.9 vs. 1.0 P=0.01), days off from work per year (19.9 vs. 5.3; P<0.001), and need for repeat cardioversions per patient (0.7 vs. 0.3; P=0.01), as well as improved subjective QoL (63% vs. 76%; P<0.001) and objective QoL (69% vs. 77%; P<0.001). There was no difference in AF recurrences between patients with paroxsymal (28%) and persistent (32%; P=0.55) AF at follow-up. Conclusion: Pts with persistent AF experienced had lower resource use and improved QoL after RFA. Our findings suggest that the benefits of RFA persist beyond 1 year in patients with both paroxysmal and persistent AF. The work was supported by grant IGA MZ NS10261-3/2009