title: Improvement in quality of life after catheter ablation for paroxysmal versus long-standing persistent atrial fibrillation: a prospective study with 3-year follow-up.
abstract: BACKGROUND
  Changes in quality of life (QoL) after catheter ablation for long-standing persistent atrial fibrillation (LSPAF) are not well described. We sought to compare QoL improvement after catheter ablation of paroxysmal atrial fibrillation (PAF) versus that after LSPAF.
  
  
  RESULTS
  A total of 261 PAF and 126 LSPAF ablation recipients were prospectively followed for arrhythmia recurrence, QoL, hospital stay, and sick leave. In PAF versus LSPAF groups, 1.3±0.6 versus 1.6±0.7 procedures were performed per patient (P<0.00001) during a 3-year follow-up. Good arrhythmia control was achieved in 86% versus 87% of patients (P=0.69) and in 69% versus 69% of patients not receiving antiarrhythmic drugs (P=0.99). The baseline QoL was better in the PAF than in the LSPAF group (European Quality of Life Group instrument self-report questionnaire visual analog scale: 66.4±14.2 versus 61.0±14.2, P=0.0005; European Quality of Life Group 3-level, 5-dimensional descriptive system: 71.4±9.2 versus 67.7±13.8, P=0.002). Postablation 3-year increase in QoL was significant in both groups (all P<0.00001) and significantly lower in PAF versus LSPAF patients (visual analog scale: +5.0±14.5 versus +10.2±12.8, P=0.001; descriptive system: +5.9±14.3 versus +9.3±13.9, P=0.03). In multivariate analysis, LSPAF, less advanced age, shorter history of AF and good arrhythmia control were consistently associated with postablation 3-year improvement in QoL. Days of hospital stay for cardiovascular reasons and days on sick leave per patient/year were significantly reduced in both groups.
  
  
  CONCLUSIONS
  Patients with LSPAF had worse baseline QoL. The magnitude of QoL improvement after ablation of LSPAF was significantly greater compared with after ablation of PAF, particularly when good arrhythmia control was achieved without the use of antiarrhythmic drugs.
authors.affiliation: Department of Cardiology and Angiology, St. Anne's University Hospital and International Clinical Research Center, Brno, Czech Republic (V.B.) Department of Cardiology and Angiology, First Faculty of Medicine, Charles University, Prague, Czech Republic (V.B., H., J., D.W.).
authors.forename: Veronika
authors.initials: V
authors.lastname: Bulková
authors.affiliation: Department of Internal Medicine and Cardiology, University Hospital, Masaryk University, Brno, Czech Republic (M.F., J.) Department of Cardiology, Hospital Podlesí, Třinec, Czech Republic (M.F., L., J.J.).
authors.forename: Martin
authors.initials: M
authors.lastname: Fiala
authors.affiliation: Department of Cardiology and Angiology, First Faculty of Medicine, Charles University, Prague, Czech Republic (V.B., H., J., D.W.).
authors.forename: Stěpán
authors.initials: S
authors.lastname: Havránek
authors.affiliation: Department of Cardiology and Angiology, First Faculty of Medicine, Charles University, Prague, Czech Republic (V.B., H., J., D.W.).
authors.forename: Jan
authors.initials: J
authors.lastname: Simek
authors.affiliation: Department of Cardiology, Hospital Podlesí, Třinec, Czech Republic (M.F., L., J.J.).
authors.forename: Libor
authors.initials: L
authors.lastname: Skňouřil
authors.affiliation: Department of Cardiology, Hospital Podlesí, Třinec, Czech Republic (M.F., L., J.J.).
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Januška
authors.affiliation: Department of Internal Medicine and Cardiology, University Hospital, Masaryk University, Brno, Czech Republic (M.F., J.).
authors.forename: Jindřich
authors.initials: J
authors.lastname: Spinar
authors.affiliation: Department of Cardiology and Angiology, First Faculty of Medicine, Charles University, Prague, Czech Republic (V.B., H., J., D.W.).
authors.forename: Dan
authors.initials: D
authors.lastname: Wichterle
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001007:Anxiety; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D015331:Cohort Studies; D003863:Depression; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D018582:Sick Leave / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult
keywords: atrial fibrillation; long‐standing persistent; paroxysmal; quality of life