Quality of life after atrial fibrillation ablation: measuring the most important end-point

Since atrial fibrillation (AF) ablations were introduced in late 1990s, there have been multiple trials evaluating the outcomes of catheter ablation of AF in comparison to medical therapy (online supplemental table 1). The majority of the trials have shown a significant reduction in arrhythmia burden with AF ablation compared with alternative therapies but almost none have shown a survival benefit from catheter ablation and/or a decrease in major adverse cardiac events (MACE) (or similar composite end-points). The International Consortium for Health Outcomes Measurement (ICHOM) has established cognitive functioning, health-related QoL, physical functioning and emotional functioning as important PROs in the management of AF.3 Previously, many AF ablation trials have evaluated QoL in patients with AF using different QoL measures and symptom checklists (online supplemental table 1). [...]cognition appears to improve slightly after ablation, regardless of outcome.