Date of Award

2021

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

OBJECTIVE: The objective of this evidence-based medicine (EBM) review was to determine whether or not catheter ablation improves quality of life in patients with atrial fibrillation compared to drug therapy.

STUDY DESIGN: Systematic review of three peer-reviewed studies published in the years 2018 and 2019. All three studies were published in English.

DATA SOURCES: Articles were selected based on their relevance to the clinical question. Additionally, all three studies placed emphasis on patient-oriented outcomes. The studies were selected via Pubmed and keyword searching. The first study selected and reviewed was an observational cohort study, the second study was a multi-center open-label randomized controlled trial (RCT), and the third and last study reviewed was an RCT with blinded outcome evaluations.

OUTCOMES MEASURED: Participants quality of life was measured by using Medical Outcomes Study 36-item Short Form Health Survey (SF-36), the Atrial Fibrillation Effect on Quality of life (AFEQT) questionnaire, the Mayo AF-Specific Symptom Inventory (MAFSI) questionnaire, and the Arrhythmia-specific questionnaire in Tachycardia and Arrhythmia (ASTA).

RESULTS: The study conducted by Barmano et al. found a statistically significant improvement in quality of life of those individuals receiving a catheter ablation (p < 0.01). The study conducted by Blomstrom et al. found a significant and positive increase in the SF-36 scores of patients receiving a catheter ablation as compared to the medication treatment group (p = 0.003). Mark et al. found a significantly higher quality of life -- as measured by both the MAFSI and AEFQT -- in patients receiving a catheter ablation as compared to a medication treatment group (both p < 0.001).

CONCLUSION: The data presented in this systematic evidence-based medicine review demonstrate a significant positive impact of catheter ablation on the quality of life in patients with atrial fibrillation. While no study is without limitations, all three studies reviewed confirmed a statistically significant improvement in quality of life. Future research studies should continue to use randomized controlled trials as well as ensuring there is no crossover between control and treatment groups.

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