Open Access Research

Health-related quality of life in different clinical subgroups with typical AFL who have undergone cavo-tricuspid isthmus ablation

Javier García Seara1*, Francisco Gude2, Pilar Cabanas1, José L Martínez-Sande1, Xesús Fernández López1, Antonio Hernández Madrid3, Concepción Moro3 and José R González Juanatey1

Author Affiliations

1 Cardiology Department, Hospital Clinico de Santiago de Compostela, Calle Choupana s/n, Santiago de Compostela 15703, Spain

2 Epidemiology Department, Hospital Clinico de Santiago de Compostela, Calle Choupana s/n, Santiago de Compostela, 15703, Spain

3 Cardiology Department, Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9.1, Madrid, 28034, Spain

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Health and Quality of Life Outcomes 2012, 10:90  doi:10.1186/1477-7525-10-90

Published: 6 August 2012

Abstract

Background

To evaluate changes in health-related quality of life (HRQOL) in different sub-groups of a cohort of patients with typical atrial flutter (AFL) treated with cavotricuspid isthmus (CTI) radiofrequency catheter ablation.

Methods

95 consecutive patients due to undergo CTI ablation were enrolled in a study involving their completion of two SF-36 HRQOL questionnaires, before ablation and at one-year follow-up.

Results

88 of the initial 95 patients finished the study. Regardless of whether patients experienced atrial fibrillation (AF) during follow-up, a statistically significant improvement in HRQOL was observed, compared with pre-ablation scores and in all dimensions except Bodily Pain. However, patients without AF during follow-up had significantly higher absolute HRQOL scores in most dimensions. No differences were seen in most HRQOL dimensions, with respect to AFL type (paroxysmal, persistent) or duration, whether AFL was first-episode or recurrent, Class I-III drug dependent, sex, or presence of structural heart disease or tachycardiomyopathy. Patients with persistent AFL showed the greatest improvement in HRQOL when they also had a ventricular cycle length ≤500 ms. The combination of recurrent AFL, ventricular cycle length ≤500 ms and structural heart disease led to a significantly greater improvement in physical HRQOL dimensions than did first-episode AFL, no structural heart disease and ventricular cycle >500 ms. The only independent factor associated with a greater improvement was structural cardiopathy.

Conclusions

CTI-ablation treatment leads to a significant improvement in HRQOL in patients with typical AFL. Patients with AF during follow-up show a significantly lower HRQOL at one-year post-ablation. The only independent risk factor found to be associated with a greater improvement in the physical summary component was structural cardiopathy.

Keywords:
Atrial flutter; Cavotricuspid isthmus ablation; Health-related quality of life