A prospective evaluation of haemodynamics, functional status, and quality of life after radiofrequency catheter ablation of long-standing persistent atrial fibrillation

Authors	FIALA Martin WICHTERLE Dan BULKOVÁ Veronika ŠKŇOUŘIL Libor NEVŘALOVÁ Renata TOMAN Ondřej ĎORDA Miloslav JANUSKA Jaroslav ŠPINAR Jindřich
Year of publication	2014
Type	Article in Periodical
Magazine / Source	Europace
MU Faculty or unit	Faculty of Medicine
Citation
Web	http://europace.oxfordjournals.org/content/16/1/15.short
Doi	http://dx.doi.org/10.1093/europace/eut161
Field	Cardiovascular diseases incl. cardiosurgery
Keywords	Atrial fibrillation; Long-standing persistent; Catheter ablation; Outcome
Description	Aims Clinical benefit from ablation for long-standing persistent atrial fibrillation has remained unknown. We hypothesized that successful ablation of long-standing persistent atrial fibrillation would improve haemodynamics, functional status, and quality of life. Methods and results A total of 160 patients (aged 59 +/- 9 years, 23% females) undergoing ablation of long-standing (median of 28 months) persistent atrial were enrolled in this prospective study. Morphological and functional echocardiographic parameters, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), maximum oxygen consumption during exercise test (VO2 max), and quality of life were assessed at baseline and 1 year after the ablation. At the 1-year follow-up visit, 81% patients were examined in sinus rhythm (after repeat ablation in 38% patients). Left atrial appendage outflow velocity increased from 44 +/- 20 to 58 +/- 23 cm/s, left ventricular ejection fraction from 54 +/- 9 to 59 +/- 5%, and VO2 max from 20.4 +/- 6.4 to 23.7 +/- 8.1 mL/kg/min; NT-proBNP decreased from median 897 (interquartile range 603 1424) to 230 (interquartile range 120 420) pg/mL (all P < 0.0001). These beneficial effects of ablation were predominantly associated with the presence of sinus rhythm. Quality of life (range 0-100) increased significantly (EQ-5D index: from 68.8 +/- 12.5 to 75.4 +/- 14.4; EQ-VAS score: from 62.8 +/- 13.2 to 70.6 +/- 13.8; both P < 0.0001). Conclusion Ablation of long-standing persistent atrial fibrillation was associated with significant recovery of haemodynamics and exercise capacity that projected onto the long-term improvement in quality of life.