Ablation is an effective, beneficial treatment option for young adults with atrial fibrillation (AFib), according to new five-year data published in Circulation: Arrhythmia and Electrophysiology.[1] The study’s authors paid close attention to patient-reported outcomes, which they said are frequently ignored in clinical research.
“Although the risk of AFib increases with age, clinical practice would suggest younger patients may be more symptomatic and hesitant to take long-term medications,” wrote first author Brett M. Johnson, MD, a researcher with Cleveland Clinic, and colleagues. “This makes durable rhythm control more desirable in younger patients, with ablation being a strategy that has the potential to eliminate the need for life-long anti-arrhythmic drugs. However, only limited data exist regarding younger adults after AFib ablation, patient-reported outcomes or otherwise.”
The group tracked data from 241 patients between the ages of 16 and 50 years old who underwent AFib ablation from 2013 to 2016 at a single institution. More than 40% of patients presented with persistent AFib.
Overall, 77.2% of patients were arrhythmia-free after the first year, including 66% of patients who presented with structural heart disease.
“These and other data support that young adults do as well as a more traditional patient population when looking at arrhythmia-free survival,” the authors wrote.
In addition, patients provided answers to Atrial Fibrillation Severity Scale (AFSS) questionnaires, and 90% of respondents experienced improvements in their quality of life (QoL) five years following the procedure.
Johnson et al. highlighted the importance of these AFSS scores and other patient-reported outcomes.
“For an intervention aimed to improve QoL such as ablation, we suggest that patient-reported outcomes should factor into the clinical decision-making when discussing AFib ablation outcomes,” the authors wrote. “The present study describes such patient-reported outcomes for young adults undergoing AFib ablation. In addition to arrhythmia-free survival, young adults report significant improvement in all measured symptom domains, including palpitations, chest pain, dyspnea at rest, dyspnea with activity, exercise intolerance, fatigue, and lightheadedness, and this benefit is sustained over the follow-up period of 5 years … these patients also experienced a significant reduction in emergency room visits or hospitalizations for AFib.”
Ayman Hussein, MD, a heart rhythm specialist with Cleveland Clinic, served as the study’s contributing author.
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