title: Health-related quality of life changes in patients undergoing repeated catheter ablation for atrial fibrillation.
abstract: OBJECTIVE
  Pulmonary vein isolation (PVI) for paroxysmal or non-paroxysmal atrial fibrillation (AF) should increase health-related quality of life (QOL).
  
  
  METHODS
  Retrospective cohort study of consecutive patients scheduled for PVI.
  
  
  METHODS
  University Medical Center.
  
  
  METHODS
  QOL was assessed using the physical (PCS) and mental (MCS) component summary scores from the SF-12v2 in patients undergoing PVI (mean 50, range 0-100, with higher scores indicating greater QOL). SF-12v2 was obtained at initial presentation (3-months) before PVI and after PVI at the end of follow-up (mean 1.7 ± 1.4 years) which included: (1) Clinical status, ECG, and 24-h ECG every 3 months, (2) trans-telephonic ECGs for 4 weeks every 3 months, or (3) continuous ECG via implanted devices. A recurrence was any atrial arrhythmia >30 s.
  
  
  RESULTS
  Out of 229 patients (73% males; 58 ± 11 years), 72% returned SF-12v2 regarding 187 PVI procedures: 56% for 1st PVI, 48% for 2nd PVI, 71% for 3rd PVI, and 44% for 4th PVI. The mean difference between before and after PVI was 10 for PCS and 9 for MCS. History of paroxysmal or non-paroxysmal AF did not influence QOL (p = 0.724). Patients with an estimated PCS improvement ≥ 10 or an estimated MCS improvement ≥ 9 had the best outcome after repeated PVI. Success rates were 72 or 82% after 1 year compared to 20 and 22% in patients not achieving this improvement, respectively (p < 0.0001).
  
  
  CONCLUSIONS
  Improvement in QOL correlates with success of AF ablation after single and repeated PVI. Assessment of QOL pre- and post-PVI can complement ECG techniques for PVI success monitoring.
authors.affiliation: Section of Internal Medicine II, Department of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. thomas.pezawas@meduniwien.ac.at.
authors.forename: Thomas
authors.initials: T
authors.lastname: Pezawas
authors.affiliation: Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
authors.forename: Robin
authors.initials: R
authors.lastname: Ristl
authors.affiliation: Section of Internal Medicine II, Department of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schukro
authors.affiliation: Section of Internal Medicine II, Department of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Herwig
authors.initials: H
authors.lastname: Schmidinger
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Ablation; Atrial fibrillation; Pulmonary vein isolation; Quality of life; Rhythm control