SPC365

Impact of Diastolic Dysfunction on Quality of Life in Atrial Fibrillation Patients Undergoing Catheter Ablation

Session: SESSÃO DE POSTERS 53 - FIBRILHAÇÃO AURICULAR E ARRITMIAS AURICULARES COMPLEXAS
Speaker: Ana Inês Aguiar Neves

Congress: CPC 2025
Topic: C. Arrhythmias and Device Therapy
Theme: 05. Atrial Fibrillation
Subtheme: 05.9 Atrial Fibrillation - Other
Session Type: Cartazes
FP Number: ---
Authors: Ana Inês Aguiar Neves; Rafael Teixeira; Inês Rodrigues; Marta Leite; Fábio Sousa Nunes; André Lobo; Marta Catarina Almeida; João G. Almeida; Helena Gonçalves; Marco Oliveira; João Primo; Ricardo Fontes-Carvalho

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Introduction:</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> Atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) frequently coexist. However, HFpEF in AF patients is a diagnostic challenge because symptoms may often be misattributed to AF rather than HFpEF. Hemodynamic assessments using echocardiography can provide objective measurements of diastolic function and guide the management of HFpEF.</span></span><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> T</span></span><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">his study aimed to evaluate the prevalence of diastolic dysfunction and its impact on quality of life (QoL) in AF patients undergoing catheter ablation.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Methods: </span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">P</span></span><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">atients with AF who underwent ablation were prospectively followed using a hybrid follow-up program, including scheduled visits and remote monitoring through a digital health platform. Transthoracic echocardiography with assessment of diastolic function was performed the day following ablation, in sinus rhythm. Moderate-to-severe diastolic dysfunction (msDD) was defined by the presence of at least two of the following parameters: 1) medial e&rsquo; &lt;7; 2) E/e&rsquo; &gt;15; 3) tricuspid regurgitation velocity &gt;2.8 m/s; and 4) left atrium volume index (LAVI) &gt;34 mL/m<sup>2</sup>. QoL was assessed using the patient-reported Atrial Fibrillation Effect on Quality-of-Life (AFEQT)&nbsp;summary score. The primary outcome was the relative change in AFEQT from baseline at 12 months after ablation. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Results: </span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">331 patients (32% female, median age 59 years) were followed for a median time of 1.7 years (IQR 1.1-2.4 years). At baseline, 65% of patients met the criteria for msDD. Patients with msDD were older (62 years vs. 56 years, <em>p</em> &lt;0.001) and were more likely to have persistent AF, dyslipidemia, and hypertension. Baseline QoL scores did not significantly differ between groups (50 &plusmn; 17 for msDD vs 52 &plusmn; 18 for controls). However, at 12 months post-ablation, patients without msDD had significantly higher AFEQT scores (73 &plusmn; 16 for msDD vs. 79 &plusmn; 17 for controls), with a clinically relevant mean improvement of 6 points (95% CI 2-10, <em>p</em>-value for interaction &lt;0.001). No significant differences in AF recurrence rates were found between groups.</span></span></span></span></p>

<p><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Conclusions</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">: Most&nbsp;patients undergoing AF ablation have signs of diastolic dysfunction on echocardiography. Although AF ablation improved QoL in this cohort, patients with msDD tend to experience some residual impairment, even without a significant increase in AF recurrence. The coexistence of diastolic dysfunction and AF increases the likelihood of HFpEF, which may be responsible for the persistence of&nbsp;symptoms previously ascribed to HF. These findings highlight the importance of comprehensive evaluation and management of diastolic dysfunction in this population.</span></span></p>