How important is the assessment of quality of life after pulmonary vein isolation for paroxysmal atrial fibrillation?

Abstract

Atrial fibrillation (AF) is one of the most common symptomatic arrhythmias. In addition to clinical symptoms, patients with AF have an increased risk of stroke and it can cause decrease in exercise tolerance and left ventricular function. The growing interest in the quality of life in patients with AF is related to recent clinical findings, such as patients with symptomatic paroxysmal AF having markedly impaired quality of life compared with a healthy index population. Patients with symptomatic AF, today often, undergo atrioventricular node ablation with permanent pacemaker implantation, primarily not to improve their survival but their daily life performance. Although quality of life is now accepted as a clinically important issue in patients with AF, the currently available data from adequately designed studies are still very limited. Therefore, it is very important to conduct more studies in a prospective and randomized fashion to assess the quality of life in patients with AF who undergo different treatment strategies. Atrioventricular node ablation with permanent pacemaker implantation, atrioventricular node modification procedures, and Maze-related catheter procedure were reported to improve quality of life in highly selected and severely symptomatic AF patients[1–3]. Recently, pulmonary veins (PVs) have been demonstrated to be the major source of ectopic beats initiating paroxysmal AF, and radiofrequency catheter ablation of PVs can successfully cure paroxysmal AF[4,5]. However, the information about quality of life after PV ablation in symptomatic … Correspondence : Shih-Ann Chen, MD, Division of Cardiology, Taipei Veterans General Hospital, 201 Sec 2, Shih-Pai Road, Taipei, Taiwan. Tel.: +866-2-28757156; Fax: +866-2-28735656. E-mail: epsachen{at}ms41.hinet.net