Nurse-led care significantly improved quality of life at 12 months postablation compared to usual care (difference +4 points; 95% CI, 1.8-6.3; P=0.0007).
RCT (n=66)
randomized
No
Does structured nurse-led care improve quality of life in patients without heart failure undergoing first-time catheter ablation for atrial fibrillation?
A structured nurse-led intervention significantly improved quality of life, reduced arrhythmia recurrences, and decreased emergency visits at 1 year in patients undergoing first-time AF ablation.
Effect estimate: Difference +4 points (95% CI 1.8-6.3)
p-value: p=0.0007
BACKGROUND: Atrial fibrillation (AF) is associated with reduced quality of life and frequent hospitalizations. Integrated nurse-led care (NLC) has proven beneficial in unselected AF patients, but evidence specific to patients undergoing catheter ablation is limited. We aimed to assess the impact of a structured nurse-led intervention in patients undergoing first-time AF ablation. METHODS: NURSECAT-AF was a single-center prospective randomized clinical trial comparing usual care with NLC, which incorporated an AF educational program, peri-procedural support, and risk factor management. Consecutive patients without heart failure referred for first-time AF ablation were randomized to NLC or usual care. NLC visits were scheduled at 15 days preablation, 15 days, and 6 months postablation. The primary end point was quality of life at 12 months postablation using the arrhythmia-specific scale in tachycardia and arrhythmia. Secondary outcomes included arrhythmia recurrence, readmissions and emergency visits, and symptom burden at 1 year and AF knowledge and satisfaction at 3 months. RESULTS: Of 116 patients screened, 66 were randomized (33 per group; mean age 63±10 years; 67% male). At 12 months, the NLC group showed statistically significant better quality of life (baseline-adjusted arrhythmia-specific scale in tachycardia and arrhythmia difference +4 points 95% CI, 1.8–6.3; P =0.0007) than usual care, and presented with less arrhythmia recurrences (odds ratio, 0.2 95% CI, 0.05–0.78) and emergency visits (odds ratio, 0.2 95% CI, 0.06–0.66). Patients assigned to NLC also presented with a lower symptom burden, higher satisfaction, and greater disease knowledge. Risk factor profile was improved in the NLC group, with higher rates of smoking cessation, engagement in regular physical activity, and weight optimization. Nurse-led management enabled more frequently diagnosing obstructive sleep apnea. CONCLUSIONS: Nurse-led, integrated care for patients undergoing AF ablation improves the quality of life, clinical outcomes, and risk factor management at 1 year postprocedure. These findings support the incorporation of structured nurse-led interventions in the peri-ablation care pathway. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT05333445.
Valls et al. (2026) conducted an RCT in Atrial fibrillation undergoing first-time catheter ablation (n=66). Nurse-led care (NLC) vs. Usual care was evaluated on Quality of life at 12 months postablation using the arrhythmia-specific scale in tachycardia and arrhythmia (Difference +4 points, 95% CI 1.8-6.3, p=0.0007). Nurse-led care significantly improved quality of life at 12 months postablation compared to usual care (difference +4 points; 95% CI, 1.8-6.3; P=0.0007).