title: Patient reported outcome measures for cardiac ablation procedures: a multicentre pilot to develop a new questionnaire.
abstract: OBJECTIVE
  To assess the feasibility of administering Patient Reported Outcomes Measures (PROMs) in patients treated with ablation for cardiac arrhythmias, and to conduct the first stage of development and testing of a new PROM tool.
  
  
  RESULTS
  A new tool was developed by a multidisciplinary team and tested alongside an adaptation of the patient perception of arrhythmia questionnaire (PPAQ) and EQ-5D-5L in a multicentre retrospective audit involving 791 consecutive cardiac arrhythmia patients treated with catheter ablation at three UK centres over 13 months. Data were recorded in the National Cardiac Rhythm Management Database, part of the National Institute for Cardiovascular Outcomes Research. The response rate was 71.9% (n = 569). Patients reported significant improvements across all outcomes and impacts, with reductions in symptoms of 51.7% (heart racing), 33.9% (fatigue) 31.8% (heart flutters), 43.5% (dizziness), 38.6% (breathlessness), 44.2% (chest pressure), 33.1% (trouble concentrating), 15.9% (headache), 28.3% (neck pressure), and 23.4% (fainting) (P < 0.001). The mean number of social days affected reduced by 7.49 days/month (P < 0.001); mean work/school days affected/month reduced by 6.26 (P < 0.001); mean GP/hospital visits reduced by 1.36 days/month (P < 0.001). The procedure met patient expectations in 72% of responders.
  
  
  CONCLUSIONS
  The high response rate suggests that the use of PROMs in this patient group is feasible, with rates equalling those of the National PROMs Programme. The results showed that patients experienced significant improvements in their quality of life following ablation, while feedback allowed the tools to be improved. Further work is required to validate these tools; however, the findings suggest that PROMs could be useful in the audit of ablation techniques.
authors.affiliation: Cedar, Cardiff and Vale University Health Board, Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ, UK kathleen.withers@wales.nhs.uk.
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Withers
authors.affiliation: Cedar, Cardiff and Vale University Health Board, Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ, UK.
authors.forename: Judith
authors.initials: J
authors.lastname: White
authors.affiliation: Cedar, Cardiff and Vale University Health Board, Cardiff Medicentre, Heath Park, Cardiff, CF14 4UJ, UK.
authors.forename: Grace
authors.initials: G
authors.lastname: Carolan-Rees
authors.affiliation: National Institute of Health and Care Excellence, 10 Spring Gardens, London, SW1A 2BU, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Patrick
authors.affiliation: Cardiology Department, Cardiff and Vale University Health Board, Heath Park, Cardiff, CF14 4UJ, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: O'Callaghan
authors.affiliation: Cardiology Department, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle Upon Tyne, NE7 7DN, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Murray
authors.affiliation: National Institute for Cardiovascular Outcomes Research, University College London Institute of Cardiovascular Outcomes, London, W1T 7HA, UK.
authors.forename: David
authors.initials: D
authors.lastname: Cunningham
authors.affiliation: Duke University, Durham, North Carolina, USA.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Wood
authors.affiliation: Cardiology Department, University Hospitals Birmingham NHS Foundation Trust, New Queen Elizabeth Hospital, Birmingham, B15 2WB, UK.
authors.forename: Mauro
authors.initials: M
authors.lastname: Lencioni
authors.affiliation: Cardiology Department, University Hospitals Birmingham NHS Foundation Trust, New Queen Elizabeth Hospital, Birmingham, B15 2WB, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Griffith
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Arrhythmia; Cardiac ablation; PROMs; Patient reported outcome measures; Quality of life