Improvement in Atrial Fibrillation-Related Symptoms After Cardioversion: Role of NYHA Functional Class and Maintenance of Sinus Rhythm

Abstract

Background The European Heart Rhythm Association (EHRA) score is a proven and validated tool for assessing the symptoms of atrial fibrillation (AF). Little is known about the variables related to this score and how it changes after cardioversion. Methods We analyzed 744 patients undergoing elective cardioversion in whom AF-related symptoms were assessed at baseline and after 6 months of follow-up using the EHRA score. We assessed the association between the EHRA score and other clinical and echocardiographic variables at baseline and after 6 months of follow-up. Results At 6 months of follow-up, we observed a reduction in the EHRA score in 50% and worsening in 2.8% of patients who remained in sinus rhythm (SR) compared with 34.6% and 11.3%, respectively, of patients with AF episodes (p<0.0001). Patients who maintained SR at 6 months were less symptomatic than those with AF (EHRA score 1.13 ± 0.35 vs 1.42 ± 0.59; p<0.0001). The independent predictors for reduction in the EHRA score after cardioversion were NYHA ≥II at baseline and maintenance of SR (p<0.0001). Conclusion The greatest improvement in AF-related symptoms was in patients who remained in SR at 6 months after cardioversion and in patients with worse NYHA functional class at baseline.

Evaluation of the Effect of Conversion of Nonvalvular Atrial Fibrillation to Sinus Rhythm on Cardiac Remodeling

“…The restoration of SR has been identified as a pivotal factor in improving patients’ quality of life. Consistent with existing literature [ 15 - 17 ], we noted significant enhancements in valvular dysfunction severity and patients' functional capacity.…”

Cryoballoon ablation for atrial fibrillation in patients with heart failure with mildly reduced and preserved ejection fraction

“…Therefore, maintaining SR improves the HF symptoms and affects the patient's main complaint, which is represented by improved NYHA. 35 Compared with the No HF group, HFpEF is mainly manifested by poor NYHA. Hence, if NYHA of HFpEF is significantly improved at the time of reassessment, it may be assessed as a recovery of HF.…”

“…AF could aggravate HF not only objectively but also subjectively affecting the patient's main complaint. Therefore, maintaining SR improves the HF symptoms and affects the patient's main complaint, which is represented by improved NYHA 35 . Compared with the No HF group, HFpEF is mainly manifested by poor NYHA.…”

Association between Psychological Capital and Self-Management Ability in Women with Atrial Fibrillation after Radiofrequency Ablation: Based on Positive Psychology Theory

“…General information questionnaire: The general information questionnaire including demographic data such as patients' age, education, marital status, personal monthly income and disease-related data such as AF duration and European Heart Rhythm Association (EHRA) symptom class [21].…”