Variations in follow-up after atrial fibrillation ablation

J Am Assoc Nurse Pract. 2020 May 6;33(8):602-610. doi: 10.1097/JXX.0000000000000424.

Abstract

Background: A multidisciplinary patient-centered approach using evidence-based care is recommended in recent atrial fibrillation (AF) guidelines to achieve quality patient outcomes. Professional society guidelines are conflicting and vague in recommendations on timing of follow-up after AF ablation.

Purpose: The aim of this secondary analysis was to examine whether the type and timing of follow-up care after AF ablation affected patient outcomes.

Methods: A 2-year, longitudinal, pilot study to explore patient experiences during the first 6 months following an AF ablation was conducted. Patients completed surveys and phone interviews before ablation, and at 1, 3, and 6 months after the ablation. Pearson correlations and repeated-measures analysis of variance were used for comparison of outcomes over time.

Results: The sample (N = 20) had a mean age of 65 (± 7) years, was 55% female, 35% paroxysmal AF, and 65% persistent AF pre-ablation. Timing of follow-up visits following AF ablation varied widely. Patients reported many concerns and difficulties reflecting the lack of knowledge and unrealistic expectations of post-ablation recovery. Better outcomes were noted in those who were seen at 1-week post-ablation by a nurse practitioner (NP) compared with those who were not seen until 1 or 3 months after ablation by a physician.

Implications for practice: Atrial fibrillation ablation is routinely performed in the United States, yet there seems to be a lack of standardization concerning the type and timing of follow-up care after AF ablation. These preliminary findings support a standardized approach to include an NP visit at one week after AF ablation to achieve quality AF patient outcomes.

MeSH terms

  • Aged
  • Atrial Fibrillation* / surgery
  • Catheter Ablation*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Pilot Projects
  • Treatment Outcome