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Background  Changes in quality of life (QoL) after catheter ablation for long‐standing persistent atrial fibrillation ( LSPAF ) are not well described. We sought to compare QoL improvement after catheter ablation of paroxysmal atrial fibrillation ( PAF ) versus that after  LSPAF .    Methods and Results  A total of 261  PAF  and 126  LSPAF  ablation recipients were prospectively followed for arrhythmia recurrence, QoL, hospital stay, and sick leave. In  PAF  versus  LSPAF  groups, 1.3±0.6 versus 1.6±0.7 procedures were performed per patient ( P <0.00001) during a 3‐year follow‐up. Good arrhythmia control was achieved in 86% versus 87% of patients ( P =0.69) and in 69% versus 69% of patients not receiving antiarrhythmic drugs ( P =0.99). The baseline QoL was better in the  PAF  than in the  LSPAF  group (European Quality of Life Group instrument self‐report questionnaire visual analog scale: 66.4±14.2 versus 61.0±14.2,  P =0.0005; European Quality of Life Group 3‐level, 5‐dimensional descriptive system: 71.4±9.2 versus 67.7±13.8,  P =0.002). Postablation 3‐year increase in QoL was significant in both groups (all  P <0.00001) and significantly lower in  PAF  versus  LSPAF  patients (visual analog scale: +5.0±14.5 versus +10.2±12.8,  P =0.001; descriptive system: +5.9±14.3 versus +9.3±13.9,  P =0.03). In multivariate analysis,  LSPAF , less advanced age, shorter history of  AF  and good arrhythmia control were consistently associated with postablation 3‐year improvement in QoL. Days of hospital stay for cardiovascular reasons and days on sick leave per patient/year were significantly reduced in both groups.    Conclusions  Patients with  LSPAF  had worse baseline QoL. The magnitude of QoL improvement after ablation of  LSPAF  was significantly greater compared with after ablation of  PAF , particularly when good arrhythmia control was achieved without the use of antiarrhythmic drugs.

journal of the american heart association

Improvement in Quality of Life After Catheter Ablation for Paroxysmal Versus Long‐standing Persistent Atrial Fibrillation: A Prospective Study With 3‐Year Follow‐up