Symptom Underrecognition of Atrial Fibrillation Patients in Consideration for Catheter Ablation: A Report From the Kics-AF Registry.

Abstract Objectives This study sought to investigate whether symptom underrecognition is associated with the application of catheter ablation. Background Atrial fibrillation (AF) symptom burden is frequently underrecognized and may affect the choice of treatment strategies. Methods A total of 3,276 patients with AF consecutively registered in a Japanese multicenter database from 2012 to 2017 were analyzed. All patients underwent AF symptom burden assessment via the symptom and daily activities domain within the Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaire. For the present analysis, 1,173 symptomatic patients (AFEQT score ≤80) with a clinical indication for catheter ablation were included. Underrecognition of symptom burden was defined as no subjective complaints checked by physicians despite self-reported AFEQT scores ≤80. Logistic regression analysis identified the predictors associated with receiving catheter ablation. Results Of the 1,173 patients (age: 68 ± 12 years, men: 61%) analyzed, 459 underwent catheter ablation (ablation group); they had lower overall AFEQT scores (p  Conclusions Underrecognition of AF symptom burden was frequently noted and was associated with less use of catheter ablation. Standardized recognition of symptoms using the application of validated questionnaires may facilitate outcome improvement.