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Association of Atrial Fibrillation Burden With Health-Related Quality of Life After Atrial Fibrillation Ablation: Substudy of the Cryoballoon vs Contact-Force Atrial Fibrillation Ablation (CIRCA-DOSE) Randomized Clinical Trial.
Samuel, Michelle; Khairy, Paul; Champagne, Jean; Deyell, Marc W; Macle, Laurent; Leong-Sit, Peter; Novak, Paul; Badra-Verdu, Mariano; Sapp, John; Tardif, Jean-Claude; Andrade, Jason G.
Afiliação
  • Samuel M; Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
  • Khairy P; Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
  • Champagne J; Department of Medicine, Université Laval, Quebec City, Quebec, Canada.
  • Deyell MW; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
  • Macle L; Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
  • Leong-Sit P; Department of Medicine, University of Western Ontario, London, Ontario, Canada.
  • Novak P; Department of Medicine, Royal Jubilee Hospital, Victoria, British Columbia, Canada.
  • Badra-Verdu M; Department of Medicine, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada.
  • Sapp J; Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
  • Tardif JC; Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
  • Andrade JG; Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
JAMA Cardiol ; 6(11): 1324-1328, 2021 11 01.
Article em En | MEDLINE | ID: mdl-34406350
Importance: Patients with atrial fibrillation (AF) have impaired health-related quality of life primarily owing to symptoms related to AF episodes; however, quality of life can be influenced by AF therapies, AF complications, the frequency of follow-up visits and hospitalizations, illness perceptions, and patient factors, such as anxiety or depression. Objective: To determine the association between change in AF burden and quality of life in the year following ablation. Design, Setting, and Participants: The current study is a secondary analysis of a prospective, parallel-group, multicenter, single-masked randomized clinical trial (Cryoballoon vs Irrigated Radiofrequency Catheter Ablation: Double Short vs Standard Exposure Duration [CIRCA-DOSE] study), which took place at 8 Canadian centers. Between September 2014 and July 2017, 346 patients older than 18 years with symptomatic, primarily low-burden AF refractory to antiarrhythmic therapy referred for first catheter ablation were enrolled. All patients received an implantable cardiac monitor at least 30 days before ablation and were followed up with up to December 2018. Data were analyzed from April 2020 to June 2021. Interventions: Patients were randomized 1:1:1 to contact force-guided radiofrequency ablation, 4-minute cryoballoon ablation, or 2-minute cryoballoon ablation. The exposure in the present analysis is the absolute difference in AF burden prior to ablation and 12 months following ablation, as evaluated by the Atrial Fibrillation Effect on Quality of Life (AFEQT) Score. Main Outcomes and Measures: Absolute difference in quality of life from baseline to 12 months postablation. Results: Of 346 included patients, 231 (66.7%) were male, and the median (interquartile range) age was 60 (52-66) years. A total of 328 patients (94.8%) had paroxysmal AF. The median (interquartile range) preablation AF burden was 2.0% (0.1-11.9), and the AF burden decreased to 0% at 12 months postablation. At 12 months, a 1-point improvement in AFEQT score was observed for every absolute reduction in daily AF burden of 15.8 minutes (95% CI, 7.2-24.4; P < .001), or every 0.63% (95% CI, 0.30-0.95; P < .001) reduction in relative AF burden from baseline. Conclusions and Relevance: In patients with primarily low-burden paroxysmal AF, the reduction in AF burden following ablation may be associated with a clinically meaningful improvement in quality of life. Trial Registration: ClinicalTrials.gov Identifier: NCT01913522.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade de Vida / Fibrilação Atrial / Ablação por Cateter / Criocirurgia / Eletrocardiografia Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: JAMA Cardiol Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Canadá País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade de Vida / Fibrilação Atrial / Ablação por Cateter / Criocirurgia / Eletrocardiografia Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: JAMA Cardiol Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Canadá País de publicação: Estados Unidos