Sustained High Quality of Life in a 5-Year Long Term Follow-up after Successful Ablation for Supra-Ventricular Tachycardia. Results from a large Retrospective Patient Cohort

Abstract

Introduction: The ablation of supraventricular tachycardias (SVT) using radiofrequency energy (RF) is a procedure with a high primary success rate. However, there is a scarcity of data regarding the long term outcome, particularly with respect to quality of life (QoL).Methods and Results: In this retrospective single-center study, 454 patients who underwent ablation of SVT between 2002 and 2007 received a detailed questionnaire addressing matters of QoL. The questionnaire was a modified version of the SF-36 Health Survey questionnaire and the Symptom Checklist – Frequency and Severity Scale.After a mean follow up of 4.5±1.3 years, 309 (68.1%) of the contacted 454 patients (269 female, 59.2%, mean age 58+/-6.5) completed the questionnaire. Despite of 27% of relapses in the study group, 91.7% considered the procedure a long-term success. The remainder of patients experienced no change in (3.7%) or worsening of (4.7%) symptoms. There were no significant differences between the various types of SVT (p=1). QoL in patients with Atrio-Ventricular Nodal Reentry Tachycardia (AVNRT) and Atrio-Ventricular Reentry Tachycardia (AVRT) improved significantly (p<0.0005 respectively p<0.043), whereas QoL in patients with Ectopic Atrial Tachycardia (EAT) showed a non-significant trend towards improvement. Main symptoms before ablation, such as tachycardia (91.5%), increased incidence of tachycardia episodes over time (78.1%), anxiety (55.5%) and reduced physical capacity in daily life (52%) were significantly improved after ablation (p<0.0001).Conclusion: The high acute ablation success of SVT persists for years in long term follow up and translates into a significant improvement of QoL in most patients.

Adverse Psychological Effects and Costs Associated with Waiting for Radiofrequency Ablation

“…The findings from this observational study indicate that waiting for RFA as a treatment for cardiac tachyarrhythmia may be associated with adverse impact in multiple dimensions. The quality of life data are consistent with those from other investigators who have looked at the impact of the procedure itself in a variety of arrhythmic substrates . However, we encountered relatively few studies in the published literature reporting on the psychological burden associated with arrhythmias themselves.…”

“…The quality of life data are consistent with those from other investigators who have looked at the impact of the procedure itself in a variety of arrhythmic substrates. [17][18][19][20][21][22][23][24][25][26] However, we encountered relatively few studies in the published literature reporting on the psychological burden associated with arrhythmias themselves. One small study including 43 patients with supraventricular tachycardia (SVT) explored functional ability, coping, health locus of control, pain, and psychosocial adjustment.…”

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia

“…10 When AF and atrial flutter coexist, 1 randomized study demonstrated that at 1-year follow-up, greater success in terms of arrhythmia suppression and quality-of-life score resulted from AF ablation (with or without atrial flutter ablation) than from atrial flutter ablation alone. 381 It may be that AF ablation alone is sufficient to control both arrhythmias, although CTI ablation reduced the early postablation arrhythmia recurrence rate. No prospective RCTs have compared the efficacy or safety of antiarrhythmic drugs with that of catheter ablation for non-CTI-dependent atrial flutter.…”

Impact of radiofrequency ablation on health-related quality of life in patients with paroxysmal supraventricular tachycardia compared with a norm population one year after treatment

“…16,17 There are retrospective studies in which patients with supraventricular tachycardia (SVT) were asked to grade their HRQOL after RFA and compare it with how they recall feeling before treatment. 18,19 However, with that methodology there is an obvious risk for bias recall, because patients' rating of HRQOL would be influenced by the ablation procedure, the outcome of the RFA, and the time the assessment is made. HRQOL preferably should be evaluated prospectively.…”