Long-term Effects of Atrioventricular Junction Ablation on Symptom Burden, Functional Capacity, and Health-Related Quality of Life in Men and Women With Symptomatic Atrial Tachyarrhythmias: A Prospective Single Center Study

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BACKGROUND: Atrioventricular junction ablation can be used when maximal tolerable pharmacological therapy cannot relieve atrial tachyarrhythmia symptoms. However, this strategy requires lifelong pacemaker therapy. OBJECTIVE: The aims in this study were to evaluate the long-term effects of atrioventricular junction ablation and explore the differences by sex on symptom burden, functional capacity, and health-related quality of life in patients with implanted pacemaker and symptomatic atrial tachyarrhythmia. METHODS: In this prospective longitudinal study, 137 patients (mean age, 74 ± 8 years; 47 men) were included. Six-minute walk test, symptom-specific, and generic self-reported instruments for measuring symptom burden, functional status, and health-related quality of life were assessed at baseline, 6 and 12 months after ablation. Analysis was performed to explore the data in the total group and by sex. RESULTS: Baseline characteristics such as mean age, type of arrhythmia, ejection fraction, and cardiac resynchronization therapy differed statistically between the sexes ( P < .05-.001). At the 12-month follow-up, the patients improved their mean walking distance by 56 m ( P < .001). At the 12-month follow-up, both sexes showed significant improvement in symptom frequency and severity ( P < .001), functional capacity ( P < .05-.001), and health-related quality of life ( P < .001). CONCLUSIONS: Both sexes benefited from this treatment. Specifically, their symptoms and physical and functional capacities improved, resulting in increased engagement in daily activities. In addition, these patients improved their health-related quality of life. The women experienced greater psychosocial effects than the men. If medical therapy fails to achieve adequate rate and symptom control for symptomatic atrial tachyarrhythmia, atrioventricular junction ablation combined with pacemaker is a safe and well-tolerated option.

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