Impact of vascular and cardiac parameters on quality of life in patients undergoing catheter ablation for atrial fibrillation.

Background

Atrial fibrillation (AF) impairs quality of life (QoL), and catheter ablation (CA) has been shown to improve QoL in symptomatic individuals. The structural and functional cardiovascular determinants of impaired QoL remain incompletely understood.

Methods

Participants with symptomatic AF scheduled for CA were prospectively enrolled and underwent pulse wave analysis (PWA, VascAssist2.0), echocardiography, and 12-lead electrocardiogram. QoL was assessed using the Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaire. Univariate Spearman rank-order correlation analyses were performed to assess associations between AFEQT scores and clinical, vascular, echocardiographic, and laboratory parameters.

Results

Eighty-three patients (52 male, 31 female) with a median age of 72 (IQR 63-80) years were included. Most participants had paroxysmal AF (82%), moderate to severe symptom severity (median EHRA score 3 (IQR 2-3)), and reduced QoL (mean AFEQT score 60 ± 19). Lower AFEQT scores correlated with higher vascular resistance (r =  - 0.64, p < 0.001), increased arterial stiffness (r =  - 0.62, p < 0.001), and elevated central systolic blood pressure (r =  - 0.38, p < 0.001). Cardiac variables significantly and inversely correlated with AFEQT scores included left ventricular (LV) ejection fraction < 50% (r =  - 0.74, p < 0.001), diastolic LV dysfunction (r =  - 0.34, p = 0.004), heart failure (r =  - 0.39, p < 0.001), and log-NT-proBNP levels (r =  - 0.38, p < 0.001).

Conclusion

Reduced QoL correlates with vascular and myocardial functional impairment in patients with AF scheduled for catheter ablation. The potential incremental value of multimodal cardiovascular assessment warrants further evaluation.