Predictive value of EHRA score in quality of life improvement in atrial fibrillation patients with low CHADS2 score after radiofrequency ablation

Abstract

Objective To evaluate the predictors of quality of life(QoL)changes in atrial fibrillation(AF)patients with low CHADS2 score 6 months after radiofrequency ablation(RFA). Methods AF patients with low CHADS2 score(CHADS2 score<2)undergoing RFA were selected from Chinese Atrial Fibrillation Registry(CAFR)from April 2011 to February 2013.The cohort was then divided into four groups according to their baseline symptoms based on European Heart Rhythm Association(EHRA). We quantified the changes of QoL from baseline to 6 months after RFA using Atrial Fibrillation Effect on QualiTy-of-life(AFEQT)questionnaire.Multivariable linear regression modeling was then conducted to determine predictive factors of the QoL changes from baseline to 6 months after RFA. Results A total of 144 patients with low CHADS2(61.20±10.12)years old were selected from CAFR.Health status improvement was marked and clinically meaningful during the six months follow-up among the EHRA Ⅱ(23.17, p<0.001), Ⅲ(32.08, p<0.001)and Ⅳ(61.73, p=0.004)groups, but no significant difference was seen in the EHRA I. Domain of treatment satisfaction was found to improve statistically significantly but not clinically meaningfully in the following 6 months after RFA in the EHRA Ⅱ(6.22, p=0.03)and Ⅲ(15.06, p<0.001)groups, but not in the EHRA Ⅰ and Ⅳ groups.The most important predictor for improved health status(OR: 2.40, 95%CI: 1.32-4.37, p=0.004)and treatment satisfaction(OR: 1.95, 95%CI: 1.02-3.73, p=0.045)after 6 months was EHRA stratification at baseline. Conclusion In most AF patients with low CHADS2 score, QoL was increased in the six months after RFA.Knowledge of the predictors of this increase may aid physicians to timely differentiate between patients who most likely will benefit most from RFA in terms of QoL. Key words: Atrial fibrillation; Radiofrequency ablation; Low CHADS2 score; Atrial Fibrillation Effect on QualiTy-of-life