Journal
JOURNAL OF THE AMERICAN ASSOCIATION OF NURSE PRACTITIONERS
Volume 33, Issue 8, Pages 602-610Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JXX.0000000000000424
Keywords
Atrial fibrillation; catheter ablation; clinical decision-making; nurse practitioners; outpatient care
Categories
Funding
- National Institutes of Health [NIH 1P30-NR014139-01]
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The type and timing of follow-up care after atrial fibrillation (AF) ablation may impact patient outcomes. Patients who were seen by a nurse practitioner (NP) at 1 week post-ablation had better outcomes compared to those who were not seen until 1 or 3 months after the procedure.
Background: A multidisciplinary patient-centered approach using evidence-based care is recommended in recent atrial fibrillation (AF) guidelines to achieve quality patient outcomes. Professional society guidelines are conflicting and vague in recommendations on timing of follow-up after AF ablation. Purpose: The aim of this secondary analysis was to examine whether the type and timing of follow-up care after AF ablation affected patient outcomes. Methods: A 2-year, longitudinal, pilot study to explore patient experiences during the first 6 months following an AF ablation was conducted. Patients completed surveys and phone interviews before ablation, and at 1, 3, and 6 months after the ablation. Pearson correlations and repeated-measures analysis of variance were used for comparison of outcomes over time. Results: The sample (N = 20) had a mean age of 65 (67) years, was 55% female, 35% paroxysmal AF, and 65% persistent AF pre-ablation. Timing of follow-up visits following AF ablation varied widely. Patients reported many concerns and difficulties reflecting the lack of knowledge and unrealistic expectations of post-ablation recovery. Better outcomes were noted in those who were seen at 1-week post-ablation by a nurse practitioner (NP) compared with those who were not seen until 1 or 3 months after ablation by a physician. Implications for practice: Atrial fibrillation ablation is routinely performed in the United States, yet there seems to be a lack of standardization concerning the type and timing of follow-up care after AF ablation. These preliminary findings support a standardized approach to include an NP visit at one week after AF ablation to achieve quality AF patient outcomes.
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