title: Health-related quality of life in different clinical subgroups with typical AFL who have undergone cavo-tricuspid isthmus ablation.
abstract: BACKGROUND
  To evaluate changes in health-related quality of life (HRQOL) in different sub-groups of a cohort of patients with typical atrial flutter (AFL) treated with cavotricuspid isthmus (CTI) radiofrequency catheter ablation.
  
  
  METHODS
  95 consecutive patients due to undergo CTI ablation were enrolled in a study involving their completion of two SF-36 HRQOL questionnaires, before ablation and at one-year follow-up.
  
  
  RESULTS
  88 of the initial 95 patients finished the study. Regardless of whether patients experienced atrial fibrillation (AF) during follow-up, a statistically significant improvement in HRQOL was observed, compared with pre-ablation scores and in all dimensions except Bodily Pain. However, patients without AF during follow-up had significantly higher absolute HRQOL scores in most dimensions. No differences were seen in most HRQOL dimensions, with respect to AFL type (paroxysmal, persistent) or duration, whether AFL was first-episode or recurrent, Class I-III drug dependent, sex, or presence of structural heart disease or tachycardiomyopathy. Patients with persistent AFL showed the greatest improvement in HRQOL when they also had a ventricular cycle length ≤500 ms. The combination of recurrent AFL, ventricular cycle length ≤500 ms and structural heart disease led to a significantly greater improvement in physical HRQOL dimensions than did first-episode AFL, no structural heart disease and ventricular cycle >500 ms. The only independent factor associated with a greater improvement was structural cardiopathy.
  
  
  CONCLUSIONS
  CTI-ablation treatment leads to a significant improvement in HRQOL in patients with typical AFL. Patients with AF during follow-up show a significantly lower HRQOL at one-year post-ablation. The only independent risk factor found to be associated with a greater improvement in the physical summary component was structural cardiopathy.
authors.affiliation: Cardiology Department, Hospital Clinico de Santiago de Compostela, Calle Choupana s/n, Santiago de Compostela 15703, Spain. javiergarciaseara@yahoo.es
authors.forename: Javier
authors.initials: J
authors.lastname: García Seara
authors.forename: Francisco
authors.initials: F
authors.lastname: Gude
authors.forename: Pilar
authors.initials: P
authors.lastname: Cabanas
authors.forename: José L
authors.initials: JL
authors.lastname: Martínez-Sande
authors.forename: Xesús
authors.initials: X
authors.lastname: Fernández López
authors.forename: Antonio Hernández
authors.initials: AH
authors.lastname: Madrid
authors.forename: Concepción
authors.initials: C
authors.lastname: Moro
authors.forename: José R González
authors.initials: JR
authors.lastname: Juanatey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001282:Atrial Flutter / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D017115:Catheter Ablation; D002908:Chronic Disease / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011788:Quality of Life; D012008:Recurrence; D012307:Risk Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014261:Tricuspid Valve / Q000601:surgery*; D014684:Venae Cavae / Q000601:surgery*