Abstract 11574: Clinical Changes and Predictors of Health Status in Patients With Atrial Fibrillation

• Published in: Circulation (New York, N.Y.) N.Y.), 2023-11, Vol.148 (Suppl_1)
• Main Authors: Miyama, Hiroshi, Ikemura, Nobuhiro, Kimura, Takehiro, Katsumata, Yoshinori, Nishiyama, Takahiko, Himeno, Yukihiro, Yano, Shuhei, Yamashita, Shuhei, Yamaoka, Kouki, Ibe, Susumu, Sekine, Otoya, Ueda, Ikuko, Kohsaka, Shun, Takatsuki, Seiji
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.148.suppl_1.11574

Abstract only Background: Recent clinical trials have shown the health status benefit of rhythm control, including catheter ablation (CA) over rate control for patients with atrial fibrillation (AF). However, the trials show population-averaged benefits, which complicates clinical interpretation; in reality, some patients may not benefit or even experience worsening health status after treatment. This study aimed to examine changes in patients' health status and identify predictors in a multicenter outpatient registry (KiCS-AF). Methods: KiCS-AF was a multicenter, prospective registry of patients with newly diagnosed AF collecting baseline and 1-year patient-reported health status. We examined changes in the Atrial Fibrillation Effect on QualiTy-of-life overall summary (AFEQT-OS) score over 1 year across different treatment strategies in patients with paroxysmal or persistent AF. We defined clinically important improvement and deterioration of health status as ≥5 points increase and decrease in AFEQT-OS score and no change as -5 to 5 points based on previous reports. Results: Overall, 1,960 patients were enrolled in this study, with mean AFEQT-OS scores of 76.7±17.7 and 85.4±14.8 at baseline and 1-year follow-up, respectively. The majority of patients (53.9%) experienced a clinically important improvement in health status, albeit a substantial number of patients experienced no change (28.7%) or worsening health status (17.4%). The proportion of patients with no change or worsening health status differed by treatment strategy (59.9%, 53.9%, and 32.0% in the rate control, antiarrhythmic drugs, and CA groups, respectively). After adjustment for baseline characteristics and AFEQT-OS scores, preserved baseline health status, older age (≥65 years), female sex, heart failure, and coronary artery disease were independent predictors of worsening health status in the overall cohort and the CA subgroup. Conclusion: In contemporary practice, a large proportion of patients showed improvement in health status, while a considerable number of patients experienced worsening or no change after intervention. Patient-centered care is essential to prevent the worsening of health status even after CA in high cardiovascular-risk, elderly, and female populations.