Catheter ablation in asymptomatic persistent atrial fibrillation significantly improved peak oxygen uptake from 18.0 to 19.4 mL/kg/min and enhanced quality of life at 12 months.
Observational (n=68)
No
Does catheter ablation improve exercise capacity and quality of life in patients with clinically asymptomatic persistent atrial fibrillation?
Catheter ablation in clinically asymptomatic persistent atrial fibrillation provides sustained improvements in objective exercise capacity and quality of life, suggesting latent functional impairment exists despite the absence of overt symptoms.
Absolute Event Rate: 19.4% vs 18%
p-value: p=< 0.05
AbstractBackground The clinical importance of catheter ablation in asymptomatic persistent atrial fibrillation (PeAF) remains uncertain, as current indications mainly focus on symptom relief. Asymptomatic patients may have unrecognized impairments in exercise capacity or quality of life (QoL), but prospective data are limited. Objective To prospectively evaluate the changes in exercise capacity and QoL post-catheter ablation in asymptomatic PeAF patients. Methods This single-center prospective observational study enrolled consecutive clinically asymptomatic PeAF patients who underwent catheter ablation between August 2021 and July 2024. Asymptomatic status was defined as modified EHRA class I without subjective symptoms. Cardiopulmonary exercise testing (CPX)—including anaerobic threshold (AT), peak oxygen uptake (peak VO2), metabolic equivalents (METs), and O2 pulse—and QoL assessments (AFQLQ and EQ-5D-5L) were performed at baseline and 3 and 12 months post-ablation. A symptomatic PeAF cohort assessed under the same protocol was included for a secondary descriptive comparison. Results Among the 68 asymptomatic PeAF patients, 52 completed the 12-month evaluation. All CPX parameters improved significantly post-ablation (AT: 12.8→14.0 mL/kg/min; peak VO2: 18.0→19.4 mL/kg/min; METs: 5.3→5.8; O2 pulse: 9.4→12.4 mL/beat; all p Conclusion Catheter ablation in asymptomatic PeAF was associated with sustained improvements in exercise capacity and QoL, suggesting that rhythm-control therapy may provide functional benefit even without overt symptoms.
Fujisawa et al. (2026) conducted an observational in Clinically Asymptomatic Persistent Atrial Fibrillation (n=68). Catheter ablation vs. Baseline (pre-ablation) was evaluated on Peak oxygen uptake (peak VO2) in mL/kg/min (p=< 0.05). Catheter ablation in asymptomatic persistent atrial fibrillation significantly improved peak oxygen uptake from 18.0 to 19.4 mL/kg/min and enhanced quality of life at 12 months.