Abstract
Background: We aimed to evaluate the association between atrial fibrillation (AF) burden, duration and number of episodes with healthcare utilisation and quality of life in patients with early paroxysmal AF without a history of AF. Methods: In this observational cohort study, we included 417 patients with paroxysmal AF from the Reappraisal of Atrial Fibrillation: interaction between hyperCoagulability, Electrical remodelling and Vascular destabilisation in the progression of AF (RACE V) Study. Patients were monitored with an insertable cardiac monitor for 1 year. Outcomes collected were healthcare utilisation, and quality of life assessed using the Atrial Fibrillation Severity Scale and EuroQol EQ-5D-5L questionnaires. Results: During 1 year of follow-up, 63 973 AF episodes were detected in 353 (85%) patients. The median AF burden was 0.7% (IQR 0.1-4.0%). AF ablation was performed more frequently in patients with intermediate-to-high AF burdens (>0.2%) (16.2% vs 5.9%, p=0.01) and longer AF episode duration (>1 hour) (15.8% vs 2.0%, p=0.01), whereas cardioversions were more frequent in patients with longer episode duration (>1 hour) (9.5% vs 0%, p=0.04) and intermediate (0.2-1.9%) (but not high) AF burdens (13.6% vs 4.2%, p=0.01). Patients with many episodes (>147) reported higher symptom severity (p=0.001). No differences in symptom severity nor in EQ-5D-5L scores according to AF burden or duration were observed. Conclusion: In patients with early paroxysmal AF, higher AF burden and longer episode duration were associated with increased rates of healthcare utilisation but not with symptoms and quality of life. Patients with a higher number of episodes experienced more severe symptoms. Trial registration number: NCT02726698.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Heart |
| Vol/bind | 110 |
| Sider (fra-til) | 1030–1039 |
| ISSN | 1355-6037 |
| DOI | |
| Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:The Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation (CVON 2014-9: Reappraisal of Atrial Fibrillation: interaction between hyperCoagulability, Electrical remodelling and Vascular destabilisation in the progression of AF (RACE V)). Unrestricted grant support from Medtronic Trading.
Funding Information:
MHJPF received consulting fees from Medtronic outside this work. MBK received speaker\u2019s honoraria from Abbott outside this work. JCN was supported by a grant from the Novo Nordisk Foundation (NNF16OC0018658). MR received consultancy fees from Bayer and InCarda Therapeutics (to the institution). MDM is an employee of Medtronic Bakken Research Center. RGT reports grants and personal fees from Medtronic and grants from St Jude Medical outside this work. In addition, RGT has a patent as co-inventor of the MyDiagnostick issued. The remaining authors declare no conflicts of interest.
Publisher Copyright:
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.