de Groot JR, et al. - In patients enrolled in the AFACT study, researchers assessed health-related Quality of Life (QoL) at 12 months after thoracoscopic surgical ablation. AFACT was performed to determine the efficacy and safety of ganglion plexus (GP) ablation in patients with symptomatic advanced atrial fibrillation (AF) undergoing thoracoscopic surgical ablation. In this study, they recognized thoracoscopic surgery for advanced AF as beneficial in terms of improvement in quality of life, regardless of additional GP ablation. In patients with no or one AF recurrence, QoL increased to the level of the general Dutch population, whereas in patients with multiple AF recurrences QoL remained lower. Persistently lower QoL seemed associated with irreversible, but not reversible procedural complications.

Methods

• Patients (n=240) underwent thoracoscopic pulmonary vein isolation with additional ablation lines in patients with persistent AF.
• Randomization of subjects was performed to additional GP ablation or control.
• At baseline, at 6 and 12 months of follow-up, short form 36 (SF-36) QoL questionnaires were collected.

Results

• For QoL analysis, 201 patients were eligible (age 59±8 years, 72% men, 68% enlarged left atrium, 57% persistent AF).
• Improvement in physical and mental health at 6 (both p<0.01) and 12 months (both p<0.01) relative to baseline was evident, and there appeared no difference between the GP (n=101) or control (n=100) groups.
• In patients with one or no AF recurrences, SF-36 subscores were similar to those in the general Dutch population after 12 months.
• Patients with multiple AF recurrences (30%) showed improvement regarding mental (p<0.01), but not physical health, and 6/8 SF-36 subscales remained below the general Dutch population.
• At 12 months, persistently diminished QoL scores were evident among patients with irreversible procedural complications.