Improvement of the Quality of Life by Catheter Ablation for Atrial
Fibrillation in Patients undergoing Hemodialysis
Abstract
Introduction: Atrial fibrillation (AF) is the most common arrhythmia in
patients undergoing hemodialysis (HD), which lowers the quality of life
(QoL) and increases the risk of dialysis related complications. The
present study aimed to evaluate the effectiveness of AF ablation on the
QoL in patients undergoing HD. Methods and Results: Nineteen patients
undergoing HD (14 men, age 68±8years, 15 paroxysmal AF) who underwent
catheter ablation (CA) of drug-refractory AF were enrolled in the study.
The ablation outcomes and procedural complications were evaluated and
compared to 1053 consecutive patients without HD who underwent AF
ablation. The Kidney Disease Quality of Life Short Form (KDQOL-SF) was
assessed to evaluate the QoL of the HD patients at baseline and six
months after the ablation. During the follow-up period of 17±13 months
after the last procedure, the arrhythmia free rate was similar (HD
patients 79% vs. non-HD patients 86%, log-rank p=0.82). There were no
life-threatening complications in any patients. The KDQOL-SF of the HD
patients six months after the ablation showed an improvement in the
physical functioning (54±23 to 68±28, p<0.01), general health
perceptions (38±17 to 48±15, p<0.01) and symptoms/problems
(75±21 to 84±13, p=0.02) as compared to the baseline. Regarding the
intradialytic symptoms, the dyspnea during HD significantly improved
after the CA in the HD patients without AF recurrence (35% to 6%,
p=0.04), while the atrial tachyarrhythmias and hypotension during HD
remained unchanged. Conclusions: CA of AF improves the QoL in patients
with chronic hemodialysis.