Symptom challenges after atrial fibrillation ablation.
Kathryn A Wood, Angel H Barnes, Sudeshna Paul and 2 others
PMID 28923248WHAT IT FOUND
After atrial fibrillation ablation, patients described a slow, six-month recovery with prolonged fatigue, unexpected bruising, high heart rates and sore throat.
Tell patients these symptoms are common and may last months, not days.
Key findings
01After ablation, 17 patients improved at least one atrial fibrillation severity class; at six months, 11 were class 0 and 3 worsened to class 4.
02Fatigue, pre-syncope, palpitations and trouble sleeping were most prevalent during the first one to three months; fatigue was quite a bit or extremely bothersome for 12 patients immediately after ablation and still reported by 25% at six months.
03Patients described unexpected bruising, anxiety about higher resting heart rates, sore throat or weakened voice, exercise intolerance and prolonged fatigue; many said they had not been warned about these symptoms or about how long they would last.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 20 patients were analysed, so the study is too small to estimate how common these symptoms are. There was no control group, so improvement over six months cannot be separated from other factors. Patients were recruited from a clinic and an atrial fibrillation website, and 26% withdrew, so the sample may be self-selected and not representative. The sample was 90% Caucasian and included only patients scheduled for a first ablation, and it excluded permanent atrial fibrillation and several serious comorbidities. The study reports symptoms and patient concerns, not a tested treatment effect.
The easy way to misread this
Do not read the six-month improvement as proof that atrial fibrillation ablation quickly restores normal activity or that patients can stop anticoagulation. There was no control group, only 20 patients, and 13 patients were continued on anticoagulation after six months.