Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
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.
Bland, Ry’n, "Does catheter ablation improve the quality of life in patients with atrial fibrillation compared to drug therapy?" (2021). PCOM Physician Assistant Studies Student Scholarship. 591.