Assessment of long-term quality of life after cavotricuspid isthmus ablation for typical atrial flutter

Abstract

BackgroundCavotricuspid isthmus (CTI) ablation is the treatment of choice in preventing recurrences of typical atrial flutter (AFl). However, little is known about long-term quality of life (QoL) after CTI ablation.Methods and resultsFrom 01/2003 to 05/2005, 94 patients who consecutively underwent typical AFl ablation were included in the study. An SF-36 health questionnaire was self-administered before ablation and at follow-up. Transformed scores were calculated, adjusted for age and sex and then normalized and standardized for the Spanish population. Additionally, the minimal important differences (MID) were calculated to assess the smallest change in QoL that patients perceived as positive. A linear regression model was constructed to assess long-term QoL predictors. All SF-36 scales were lower than Spanish population scores. After a mean (SD) follow-up of 6.25 (0.5) years, all scales, except Bodily Pain, were higher than baseline. There was a significant difference for Physical Role (46.4 vs. 38.6, p < 0.001), Vitality (44.4 vs. 41.9, p = 0.038) and Mental Health (46.1 vs. 42.0, p = 0.001). However, only Physical Role achieved the criteria for MID. Recurrence of AFl, basal QoL, history of diabetes mellitus, atrial fibrillation and oral anticoagulation were predictors of long-term QoL.ConclusionCTI ablation provides a significant improvement in long-term QoL for the dimensions of Physical Role, Vitality and Mental Health, although the smallest positive change that patients perceive as positive was only observed for Physical Role. Previous diabetes mellitus, atrial fibrillation, oral anticoagulation, basal QoL and AFl recurrence were determinants of a worse long-term QoL.

Heart failure and atrial flutter: a systematic review of current knowledge and practices

“… 12 , 13 Ablation of AFL in unselected patients is associated with decreased hospitalizations, emergency department visits, development of subsequent AF, 18 and improved quality of life. 1 , 19 Guidelines therefore recommend it as first‐line therapy. 20 However, few studies included patients with HF, and there are no randomized controlled trials in patients with AFL and HF.…”

“…By contrast, single‐procedure ablation success rates exceed 90% for typical and atypical AFL, 2 with associated acute complication rates of 3–11% 12,13 . Ablation of AFL in unselected patients is associated with decreased hospitalizations, emergency department visits, development of subsequent AF, 18 and improved quality of life 1,19 . Guidelines therefore recommend it as first‐line therapy 20 .…”

Symptoms and quality of life in patients with coexistent atrial fibrillation and atrial flutter

“…Cavotricuspid isthmus (CTI) ablation is the treatment of choice for recurrent and symptomatic AFL, with a high procedural success rate [24] and significant QoL improvement [25]. However, coexistent AF is frequently unmasked after CTI ablation for AFL [14,26].…”

“…Furthermore, it has been demonstrated that stand-alone pulmonary vein isolation prevents recurrence of AFL, even without CTI ablation [29]. Considering the strong impact of CTI ablation on the arrhythmia recurrence and that symptoms are usually linked to the arrhythmia burden [30], as well as the fact that an improvement in quality of life could be demonstrated for patients after CTI ablation [25], we subdivided the group of patients with coexistent AF and AFL in those with and without a history of CTI ablation. We observed that patients who underwent CTI ablation had significantly more symptoms, and particularly more palpitations, than patients without CTI ablation and patients with AF only.…”

Análise De Questionário Para Avaliação De Pacientes Com Arritmias Cardíacas

“…Descrevem-se, quanto à avaliação psicométrica, na figura 4, os testes realizados em cada questionário, sendo que apenas um estudo não apresentava avaliação psicométrica 20 e, quanto à avaliação da confiabilidade, dez questionários avaliavam a consistência interna por meio do α- Lembra-se que esta revisão integrativa buscou identificar, na literatura, instrumentos disponíveis que avaliam sintomas e/ou QVRS em pacientes com taquiarritmias. Encontraram-se estudos que avaliam a QVRS em pacientes com arritmia, submetidos a procedimentos de ablação, [34][35][36][37][38][39][40][41][42][43][44][45][46] ao tratamento farmacológico das arritmias, [47][48][49][50][51][52][53] bem como em pacientes com FA submetidos à intervenção educacional de Enfermagem, além de estudos que abordam a QVRS, em geral, de DISCUSSÃO pacientes, incluindo aspectos psicológicos como a ansiedade e depressão, [57][58][59][60][61][62][63][64] bem como atividades da vida diária, como sono e direção de veículos. Encontraram-se, quanto aos instrumentos, estudos referentes a 11 questionários.…”