Abstract 633: Unique AF-Specific Symptom Score Assesses Long-Term Symptom Relief After Ablation
Introduction: Ablation is indicated in pts with highly symptomatic atrial fibrillation (AF). While trials of ablation report favorable rhythm and quality of life (QoL) outcomes, corroborative data on AF symptom burden is scarce.
Methods: Therefore, we designed the Mayo AF-Specific Symptom Inventory (MAFSI). The inventory is a checklist of 12 individual symptom frequencies graded from 0 to 4. Composite scores range from 0 to 48. Among pts in our ablation registry, baseline MAFSI’s were completed in 276 (age 56.8±10.1, 46% paroxysmal AF, AF duration 7.2±6.4, 40% left atrial size≥45mm). Annual questionnaires were used to assess recurrence, SF-36 QoL scores, and MAFSI scores.
Results: In 101 pts with 2 yr follow-up, MAFSI scores decreased from 25.9±6.5 at baseline to 18.1±6.9 (p<0.001). Clinically significant improvements (i.e. a reduction in frequency of symptoms by at least one grade) were noted in palpitations, tiredness, and inability to exercise (all p<0.001). Among 101 pts, AF elimination was achieved in 75 pts and AF control on anti-arrhythmic drugs (AAD’s) was achieved in an additional 16 pts, leaving 10 pts with recurrent AF. Greater reductions in MAFSI scores from baseline were seen in pts with AF elimination (Δ= −9.5, CI −15.8 to −3.2) compared to pts with AF control on AAD’s (Δ = −5.6, −9.4 to −1.8, p=0.03) or recurrent AF (Δ= +3.4, −5.4 to 11.8, p=0.02). Post-ablation changes in MAFSI scores moderately correlated with improvement in SF-36 scores (Figure⇓).
Conclusion: The easy to use, Mayo AF-Specific Symptom Inventory score closely follows rhythm status after ablation and complements generic QoL outcomes.