Variations in follow-up after atrial fibrillation ablation.
Kathryn A Wood, Angel H Barnes
PMID 32384360WHAT IT FOUND
After AF ablation follow-up varied widely.
Patients seen by a nurse practitioner at one week reported less anxiety, fewer symptoms, and more confidence, but this small pilot cannot show the visit caused improvement.
Key findings
01Patients who saw a nurse practitioner at 1 week had lower anxiety at 1 month and reported better confidence managing symptoms than patients not seen until 1 or 3 months.
02Patients reported confusion about whom to contact after ablation and said recovery was slower than they expected.
03Anxiety, fatigue, and symptom scores were highest before ablation and decreased over time after ablation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a small pilot study with only 20 patients who completed all measurement points, so the findings are preliminary. The sample was a convenience sample recruited largely from an online atrial fibrillation website and was well educated, which may limit generalisability. Most patients were recruited online, and the study did not capture barriers such as transportation, parking costs, or lack of insurance that may affect access to follow-up visits. Follow-up patterns were observed, not randomised, so patients seen at 1 week by an NP or PA may have differed from other patients in ways that also affected outcomes. The study cannot separate the effect of the 1-week timing from the effect of receiving care from an NP or PA. The study included only patients having their first ablation and excluded permanent AF, so it does not apply to all AF patients.
Declared interests
One author, K.A. Wood, is a consultant with Milestone Pharmaceuticals, Inc.; the remaining author reported no conflicts of interest.
The easy way to misread this
Do not conclude that a 1-week nurse practitioner visit caused lower anxiety or fewer symptoms. This was a small, non-randomised pilot, and the 1-week visit, provider type, and usual care were not separated.