Quality-of-life in patients with paroxysmal atrial fibrillation after catheter ablation: results of long-term follow-up.

Paroxysmal atrial fibrillation (PAF) significantly impairs patients' quality-of-life (QOL). The effect on QOL of recently developed ablation techniques with curative intention has not been studied. Thirty patients (21 men, age 54.1 +/- 9.5 years) with PAF (duration 5.6 +/- 5.2 years) who failed antiarrhythmic (3.8 +/- 1.2 trials) drug therapy underwent catheter ablation. The follow-up time was 33.9 +/- 11 months. QOL was assessed preablation, 3, 6, 9, 12, 24, and 36 months after catheter ablation. The Medical Outcomes Survey Short-Form (SF-36), scored on a 0-100 scale for each of eight domains: bodily pain, general health, mental health, physical functioning, role-emotional, role-physical, social functioning, and vitality, was used. Simultaneously, patients filled out a symptom-specific checklist (SSC) with seven clinical items scored 1-4 (1 best): dyspnea, nausea, palpitations, anxiety, syncope, presyncope, and NYHA classification. Patients with successful catheter ablation had a significant benefit in seven of eight subscales while patients with recurrence had an impact on QOL in two of eight subscales. Using SSC, a successful ablation influenced scores in all seven items while patients with recurrence had a significant change of clinical symptoms in only one item, anxiety. The subscales of the study group compared to a healthy population show higher scores after 24 months of follow-up. Patients with PAF experience a significant improvement in QOL after a successful catheter ablation. In contrast, in patients with recurrence of PAF the QOL showed improvement to a lesser extent and patients experienced ongoing symptoms.