AF ablation improves psychological health of patients besides reducing cardiac symptoms: REMEDIAL trial

During the 12-month follow-up period, patients who underwent ablation were significantly less likely than those treated with medical therapy alone to have documented AF on monitoring (47% vs 96%) and had a lower median AF burden (0 vs 15.5%).

Moreover, ablation-treated patients were less likely than controls to be taking an antiarrhythmic drug or a beta-blocker at 12 months.

For the primary endpoint, the mean HADS score at 12 months was significantly lower in the ablation arm, with a difference observed for both the anxiety and depression components.

Secondary outcomes also favored ablation—there was a lower proportion of patients reporting severe psychological distress (10.2% vs 31.9%) as well as a lower mean Beck Depression Inventory-II score and University of Toronto AF symptom severity score.

“The REMEDIAL trial nicely demonstrates what happens when AF symptom burden is reduced: depression and anxiety symptoms concomitantly decrease while measures of quality of life significantly improve, promoting the freedom of patients to engage in physical and social activities,” noted Lurz et al in an accompanying editorial.

It is expected that these results will provide more evidence for patients that AF ablation over the long term can potentially the decreased use of antiarrhythmic drugs, oral anticoagulants, and the reduction in AF burden can lead them to have a better quality of life.

Source: JAMA Cardiology:

1. JAMA. 2023;330(10):925-933. doi:10.1001/jama.2023.14685

2. JAMA. 2023;330(10):919-920. doi:10.1001/jama.2023.6484