title: Relationship of quality of life with procedural success of atrial fibrillation (AF) ablation and postablation AF burden: substudy of the STAR AF randomized trial.
abstract: BACKGROUND
  The Substrate and Trigger Ablation for Reduction of Atrial Fibrillation (STAR AF) trial compared 3 strategies for ablation of high-burden paroxysmal/persistent atrial fibrillation (AF): complex fractionated electrogram ablation (CFE), pulmonary vein isolation (PVI), or a combined approach (PVI with CFE). This subanalysis aimed to identify the effect on quality of life (QOL) conferred by ablation strategy, AF recurrence, and type of AF.
  
  
  METHODS
  The STAR AF study (n = 100) found 88%, 68%, and 38% freedom from AF > 30 seconds at 12 months for PVI with CFE, PVI, and CFE approaches, respectively (P = 0.001). QOL was measured before ablation and at 12 months after ablation using the Short-Form Health Survey (SF-36) scale. Transformed scores were calculated for each of the 8 subscales of the SF-36, and also converted to physical health and mental health component scores.
  
  
  RESULTS
  There was a significant improvement in physical health (24%) and mental health (19%) component scores from baseline to 12 months after ablation (P < 0.05 for both). Significant QOL improvements were seen for all 3 ablation strategies despite differences in outcome. QOL measurements also improved regardless of AF recurrence, except in patients with an AF burden in the highest quartile (median 27.2 hours per month). AF recurrence independently predicted aggregate QOL score.
  
  
  CONCLUSIONS
  QOL after AF ablation improves regardless of procedural outcome. QOL scores were only negatively affected in patients with a high symptomatic burden of arrhythmia recurrence suggesting that significant reduction in AF burden can improve QOL without total elimination of AF.
authors.affiliation: Ospedale Regionale di Treviso, Treviso, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Mantovan
authors.forename: Laurent
authors.initials: L
authors.lastname: Macle
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Martino
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Morillo
authors.forename: Paul
authors.initials: P
authors.lastname: Novak
authors.forename: Vittorio
authors.initials: V
authors.lastname: Calzolari
authors.forename: Yaariv
authors.initials: Y
authors.lastname: Khaykin
authors.forename: Peter G
authors.initials: PG
authors.lastname: Guerra
authors.forename: Girish
authors.initials: G
authors.lastname: Nair
authors.forename: Esteban G
authors.initials: EG
authors.lastname: Torrecilla
authors.forename: Atul
authors.initials: A
authors.lastname: Verma
mesh_terms: D001281:Atrial Fibrillation / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000601:surgery; D011788:Quality of Life; D016896:Treatment Outcome