Impact of Chronic Obstructive Pulmonary Disease on Procedural Outcomes and Quality of Life in Patients with Atrial Fibrillation Undergoing Catheter Ablation

Abstract

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a risk factor for atrial fibrillation (AF). The aim of this study was to investigate the impact of COPD on outcomes of catheter ablation in patients with AF in terms of recurrence and quality of life (QoL). METHODS: In this prospective study, 550 consecutive patients with symptomatic, medication-refractory AF underwent first catheter ablation. Patients were classified into those with COPD (group 1, n = 54) and those without COPD (group 2, n = 496). Patients were followed up for atrial tachyarrhythmia (ATa) recurrence for at least 24 months. The Medical Outcomes Study SF-36 Health Survey was used to assess QoL at baseline and 24 months after ablation. RESULTS: After a single ablation, 24 patients in group 1 (44.4%) and 142 in group 2 (28.6%) had ATa recurrence during a mean follow-up of 31.4 ± 4.8 months (P = 0.016). The second ablation was performed in 19 patients (35.2%) from group 1 and in 109 patients (22.0%) from group 2 (P = 0.029). Multivariate logistic analysis showed that nonparoxysmal AF (P = 0.013, OR = 1.767, 95% CI: 1.129-2.765) as well as the presence of COPD (P = 0.029, OR = 1.951, 95% CI: 1.070-3.557) was the independent predictor for higher ATa recurrence. Moreover, patients in group 1 had significantly lower baseline scores on all SF-36 Health Survey subscales. At 24-month follow-up, both mental component summary and physical component summary scores improved markedly in group 1 and 2. CONCLUSIONS: Although the presence of COPD predicted higher recurrence after single-catheter ablation in AF patients, significant improvements in QoL were observed in the postablation COPD population.