title: A prospective evaluation of haemodynamics, functional status, and quality of life after radiofrequency catheter ablation of long-standing persistent atrial fibrillation.
abstract: OBJECTIVE
  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.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, Heart Centre, Hospital Podlesí a.s., Třinec 739 61, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Fiala
authors.forename: Dan
authors.initials: D
authors.lastname: Wichterle
authors.forename: Veronika
authors.initials: V
authors.lastname: Bulková
authors.forename: Libor
authors.initials: L
authors.lastname: Sknouril
authors.forename: Renáta
authors.initials: R
authors.lastname: Nevralová
authors.forename: Ondrej
authors.initials: O
authors.lastname: Toman
authors.forename: Miloslav
authors.initials: M
authors.lastname: Dorda
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Januska
authors.forename: Jindrich
authors.initials: J
authors.lastname: Spinar
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000523:psychology*; D002908:Chronic Disease; D003863:Depression / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D020127:Recovery of Function; D016896:Treatment Outcome
keywords: Atrial fibrillation; Catheter ablation; Long-standing persistent; Outcome