Abstract 18533: Walking on Eggshells: Patient Narratives of Recovery After Atrial Fibrillation Ablation
Introduction: Atrial Fibrillation (AF), the most common irregular heart rhythm worldwide, is now considered an epidemic. Ablation is a highly successful, curative procedure in most arrhythmias except AF. The first six months after an AF ablation can be wrought with more arrhythmias and symptoms than before the procedure. This study explored the patient’s perspective of the challenges faced during the first six months following an AF ablation.
Methods: Our longitudinal mixed methods study used interviews and questionnaires at baseline and at 1, 3, and 6 months following AF ablation treatment in 20 AF patients. Subjects were recruited from an online AF patient website to obtain geographic diversity. Subjects also wore a Zio®Patch monitor at each of the measurement points to correlate symptoms with underlying cardiac rhythm. Grounded theory analysis was used for the qualitative data. A repeated measure ANOVA was used to compare changes in quantitative scores over time.
Results: Mean age = 64 ± 14 years and the sample was 55% female. Qualitative analysis themes included: (1) seeking reassurance and meaning of symptoms were constant throughout the six months; (2) struggling with feelings of isolation, fatigue, and anxiety were common yet varied across the six months; (3) patient expectations of treatment outcome varied greatly from provider expectations; (4) managing symptoms and drug changes was very challenging work for patients. Patterns of fatigue and anxiety expressed during the interviews correlated with the quantitative scores. Patients felt that standard educational preparation was inadequate in both content and timing. Many patients were using smart phone apps and websites for information and reassurance that the providers were not aware of.
Conclusions: Despite the AF epidemic, patients struggled in perceived isolation with little direction from providers. Quicker recognition by health care providers of the most common challenges patients face in following AF ablation could lead to earlier diagnosis and more targeted interventions based on their needs. By obtaining these insights into patients’ perspectives on AF and treatment, providers learn to develop interventions specifically aimed at the challenges patients feel are most difficult.
Author Disclosures: K. Wood: None. A. Barnes: None. K. Hines: None.
- © 2015 by American Heart Association, Inc.