PO-01-013 ABLATION IMPROVES PHYSICAL ACTIVITY IN PERSISTENT ATRIAL FIBRILLATION

Abstract

There are many potential benefits to ablation of atrial fibrillation (AF), but the impact on functional status has not yet been thoroughly investigated. Activity sensors in implanted cardiac devices provide a novel opportunity for an investigation. In addition, there may be a difference between patients with paroxysmal or persistent AF. The purpose of this study was to examine the impact of AF ablation on objective behavioral data using physical activity sensor data in patients with implanted cardiac devices. Patients in the UNC Cardiac Device Surveillance Registry with a history of AF who underwent AF ablation and had their device implanted at least 90 days prior to ablation were included. Patients were stratified into paroxysmal or persistent groups based on clinical diagnosis codes. Included patients had continuous activity data from at least 60 days prior to and 90 days after ablation. Activity from hospitalized days were excluded. We used linear mixed-effects models with daily physical activity values (minutes per day) as the unit of analysis to estimate the association between AF ablation and physical activity. There were 45 persistent and 115 paroxysmal AF patients in the cohort. Mean age was 70.7 yrs (68.6 persistent, 71.6 paroxysmal) and 60 (37.5%) were female. Implanted devices included 54.9% pacemakers, 36.3% defibrillators, and 8.8% implantable loop recorders. Comorbidities included hypertension (95.7%), heart failure (74.8%), diabetes (40.9%), sleep apnea (33%), history of stroke (17.4%), and history of myocardial infarction (76.5%). There was no difference in age, device type, or comorbidity between paroxysmal and persistent patients. Persistent AF patients had a 14.6 minute increase in daily activity after ablation (p<0.001), while paroxysmal patients did not experience meaningful change in activity levels (-1.6 minutes, p=0.192). This study demonstrated an increase in objectively-measured physical activity after AF ablation in patients with implanted cardiac devices and persistent AF. No activity benefit was observed in devices patients with paroxysmal AF. Further research in larger samples is needed to replicate these findings and to determine whether improvement in functional tolerance may be an underappreciated benefit of ablation.