Changes in quality of life, cognition and functional status following catheter ablation of atrial fibrillation

Jonathan P Piccini; Derick M Todd; Tyler Massaro; Aimee Lougee; Karl Georg Haeusler; Benjamin Blank; Joseph Paul de Bono; David J Callans; Arif Elvan; Thomas Fetsch; Isabelle Van Gelder; Philip Gentlesk; Massimo Grimaldi; Jim Hansen; Gerhard Hindricks; Hussein Al-Khalidi; Lluis Mont; Jens Cosedis Nielsen; Georg Noelker; Tom De Potter; Daniel Scherr; Ulrich Schotten; Sakis Themistoclakis; Johan Vijgen; Luigi Di Biase; Paulus Kirchhof

doi:10.1136/heartjnl-2020-316612

Changes in quality of life, cognition and functional status following catheter ablation of atrial fibrillation

Jonathan P Piccini, Derick M Todd, Tyler Massaro, Aimee Lougee, Karl Georg Haeusler, Benjamin Blank, Joseph Paul de Bono, David J Callans, Arif Elvan, Thomas Fetsch, Isabelle Van Gelder, Philip Gentlesk, Massimo Grimaldi, Jim Hansen, Gerhard Hindricks, Hussein Al-Khalidi, Lluis Mont, Jens Cosedis Nielsen, Georg Noelker, Tom De PotterDaniel Scherr, Ulrich Schotten, Sakis Themistoclakis, Johan Vijgen, Luigi Di Biase, Paulus Kirchhof

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20 Citationer (Scopus)

Abstract

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 CHA2DS2-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.

Originalsprog	Engelsk
Tidsskrift	Heart (British Cardiac Society)
Vol/bind	106
Udgave nummer	24
Sider (fra-til)	1919-1926
Antal sider	8
ISSN	1355-6037
DOI	https://doi.org/10.1136/heartjnl-2020-316612
Status	Udgivet - dec. 2020

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10.1136/heartjnl-2020-316612

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Piccini, J. P., Todd, D. M., Massaro, T., Lougee, A., Haeusler, K. G., Blank, B., de Bono, J. P., Callans, D. J., Elvan, A., Fetsch, T., Van Gelder, I., Gentlesk, P., Grimaldi, M., Hansen, J., Hindricks, G., Al-Khalidi, H., Mont, L., Nielsen, J. C., Noelker, G., ... Kirchhof, P. (2020). Changes in quality of life, cognition and functional status following catheter ablation of atrial fibrillation. Heart (British Cardiac Society), 106(24), 1919-1926. https://doi.org/10.1136/heartjnl-2020-316612

Piccini, JP, Todd, DM, Massaro, T, Lougee, A, Haeusler, KG, Blank, B, de Bono, JP, Callans, DJ, Elvan, A, Fetsch, T, Van Gelder, I, Gentlesk, P, Grimaldi, M, Hansen, J, Hindricks, G, Al-Khalidi, H, Mont, L, Nielsen, JC, Noelker, G, De Potter, T, Scherr, D, Schotten, U, Themistoclakis, S, Vijgen, J, Di Biase, L & Kirchhof, P 2020, 'Changes in quality of life, cognition and functional status following catheter ablation of atrial fibrillation', Heart (British Cardiac Society), bind 106, nr. 24, s. 1919-1926. https://doi.org/10.1136/heartjnl-2020-316612

@article{a6a37389df66410fb46289d9ae56a364,

title = "Changes in quality of life, cognition and functional status following catheter ablation of atrial fibrillation",

abstract = "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 CHA2DS2-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.",

keywords = "atrial arrhythmia ablation procedures, atrial fibrillation, quality and outcomes of care",

author = "Piccini, {Jonathan P} and Todd, {Derick M} and Tyler Massaro and Aimee Lougee and Haeusler, {Karl Georg} and Benjamin Blank and {de Bono}, {Joseph Paul} and Callans, {David J} and Arif Elvan and Thomas Fetsch and {Van Gelder}, Isabelle and Philip Gentlesk and Massimo Grimaldi and Jim Hansen and Gerhard Hindricks and Hussein Al-Khalidi and Lluis Mont and Nielsen, {Jens Cosedis} and Georg Noelker and {De Potter}, Tom and Daniel Scherr and Ulrich Schotten and Sakis Themistoclakis and Johan Vijgen and {Di Biase}, Luigi and Paulus Kirchhof",

note = "{\textcopyright} Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.",

year = "2020",

month = dec,

doi = "10.1136/heartjnl-2020-316612",

language = "English",

volume = "106",

pages = "1919--1926",

journal = "Heart (British Cardiac Society)",

issn = "1355-6037",

publisher = "BMJ Publishing Group",

number = "24",

}

TY - JOUR

T1 - Changes in quality of life, cognition and functional status following catheter ablation of atrial fibrillation

AU - Piccini, Jonathan P

AU - Todd, Derick M

AU - Massaro, Tyler

AU - Lougee, Aimee

AU - Haeusler, Karl Georg

AU - Blank, Benjamin

AU - de Bono, Joseph Paul

AU - Callans, David J

AU - Elvan, Arif

AU - Fetsch, Thomas

AU - Van Gelder, Isabelle

AU - Gentlesk, Philip

AU - Grimaldi, Massimo

AU - Hansen, Jim

AU - Hindricks, Gerhard

AU - Al-Khalidi, Hussein

AU - Mont, Lluis

AU - Nielsen, Jens Cosedis

AU - Noelker, Georg

AU - De Potter, Tom

AU - Scherr, Daniel

AU - Schotten, Ulrich

AU - Themistoclakis, Sakis

AU - Vijgen, Johan

AU - Di Biase, Luigi

AU - Kirchhof, Paulus

PY - 2020/12

Y1 - 2020/12

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 CHA2DS2-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 CHA2DS2-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 - atrial arrhythmia ablation procedures

KW - atrial fibrillation

KW - quality and outcomes of care

UR - http://www.scopus.com/inward/record.url?scp=85094652573&partnerID=8YFLogxK

U2 - 10.1136/heartjnl-2020-316612

DO - 10.1136/heartjnl-2020-316612

M3 - Journal article

C2 - 33046527

SN - 1355-6037

VL - 106

SP - 1919

EP - 1926

JO - Heart (British Cardiac Society)

JF - Heart (British Cardiac Society)

IS - 24

ER -

Changes in quality of life, cognition and functional status following catheter ablation of atrial fibrillation

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