The mean (SD) follow-up was 6.26 (0.5) years and was completed for 96.8% of patients. Assessment of QoL with the SF-36Īll 94 patients included in the study self-administered the SF-36 during the 24–48 hours pre-ablation procedure and at follow-up. The exclusion criteria were: a) atypical AFl (non CTI-dependent), b) patients with an implantable cardiac defibrillator (ICD), c) patients who had undergone cardiac surgery or invasive cardiac procedures (coronary angioplasty or cardiac stimulation devices) in the previous month, and d) those patients with a life expectancy of less than one year or patients who were unable to complete the questionnaire. The inclusion criteria were: a) aged over 18 years, b) the presence of one or more episodes of documented AFl in the previous six months, and c) a demonstration by electrophysiological study of either CTI-dependent AFl or CTI permeability, accompanied by an electrocardiogram taken during a clinical episode consistent with typical AFl in those cases in which the procedure was performed in sinus rhythm. We also evaluated factors related to long-term QoL.Ī total of 94 patients admitted consecutively to our institution for typical AFl ablation between January 2003 and May 2005 were included in the study. We did this using the SF-36 questionnaire, which is widely used and validated, and also a new tool for determining the minimal important differences (MID). Our objective was to assess long-term QoL (more than five years) and to evaluate the differences between basal and long-term QoL in patients who had undergone a typical AFl ablation procedure. There are only a few studies published about QoL furthermore, in those studies, QoL is assessed using different questionnaires, with short- to medium-term follow-up periods. However, there is little information available about the quality of life (QoL) in patients who have undergone typical AFL ablation. For these reasons, CTI ablation is a first-line treatment. The success rate of this technique is currently high (90 to 100%) and complications are extremely rare. The cavotricuspid isthmus (CTI) is a critical component of the circuit its ablation is the technique available to block the circuit. The anterior barrier of the activation wave is formed by the tricuspid annulus, while the posterior barrier is formed by the crista terminalis, the eustaquian ridge and its prolongation, the eustaquian valve. Typical atrial flutter (AFl) is characterized by a macroreentry circuit around the tricuspid annulus this circuit contains a propagating wave and an excitable gap. Previous diabetes mellitus, atrial fibrillation, oral anticoagulation, basal QoL and AFl recurrence were determinants of a worse long-term QoL. ConclusionĬTI ablation provides a significant improvement in long-term QoL for the dimensions of Physical Role, Vitality and Mental Health, although the smallest positive change that patients perceive as positive was only observed for Physical Role. Recurrence of AFl, basal QoL, history of diabetes mellitus, atrial fibrillation and oral anticoagulation were predictors of long-term QoL. However, only Physical Role achieved the criteria for MID. There was a significant difference for Physical Role (46.4 vs. After a mean (SD) follow-up of 6.25 (0.5) years, all scales, except Bodily Pain, were higher than baseline. All SF-36 scales were lower than Spanish population scores. A linear regression model was constructed to assess long-term QoL predictors. Additionally, the minimal important differences (MID) were calculated to assess the smallest change in QoL that patients perceived as positive. Transformed scores were calculated, adjusted for age and sex and then normalized and standardized for the Spanish population.
An SF-36 health questionnaire was self-administered before ablation and at follow-up. Methods and resultsįrom 01/2003 to 05/2005, 94 patients who consecutively underwent typical AFl ablation were included in the study. However, little is known about long-term quality of life (QoL) after CTI ablation. Cavotricuspid isthmus (CTI) ablation is the treatment of choice in preventing recurrences of typical atrial flutter (AFl).
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