Impact of atrial fibrillation ablation on activity minutes in patients with cardiac implantable electronic devices

Abstract

Background: Impaired quality of life due to atrial fibrillation (AF), which often includes decreased activity level, is an indication for ablation. However, the impact of ablation for AF on activity is poorly understood.

Objective: The purpose of this study was to assess the impact of ablation on activity minutes per day using continuous accelerometer data from cardiac implantable electronic devices (CIEDs).

Methods: Using the Optum® Health Record dataset (2007-2019) linked with the Medtronic CareLink® database, we identified patients who had a CIED with AF detection and accelerometer capabilities. Patients with a device that transmitted heart rhythm and activity data ≥3 months before and ≥12 months after ablation were included in analysis. The associations between ablation and activity minutes were assessed for each CIED type.

Results: Of 4297 eligible patients who underwent AF ablation, 409 (9.5%) (65% male; age 67.3 ± 9.8 years; 64% paroxysmal AF) were included in analysis. The average AF burden and activity minutes per day preablation were 30.9% ± 37.4% and 175 ± 99 minutes, respectively. After ablation, relative AF burden decreased by 75.1% ± 53.2% (P <.001). There was no change in activity minutes per day after ablation in the entire cohort (average change -0.10 ± 36.2 minutes; P = .96). There were also no clinically significant changes in activity minutes postablation in subgroups based on CIED, season of ablation, quartile of AF burden change, and quartile of age at the time of ablation.

Conclusion: There were no clinically significant changes in activity minutes per day in patients with CIEDs after ablation for AF.

Keywords: Ablation; Activity; Atrial fibrillation; Modification; Risk factor.