Arrhythmias & electrophysiology
Atrial Arrhythmia Burden (SMURDEN) After Ablation of Atrial Fibrillation (AF) Is Associated With Improvement in Quality of Life
Authors' conclusion
Patients who experienced AF recurrence reported diminished symptom and QoL improvements. SMURDEN emerged as the most significant predictor of symptom improvement and was the only independent factor associated with a lack of improvement or worsening of symptoms.
Study context
- Population
- Patients with persistent AF with symptom severity scores before and after ablation
- Participants
- 750 patients
- Comparison
- Magnetic resonance imaging (MRI)-guided fibrosis ablation plus pulmonary vein isolation (PVI) vs PVI alone
- Primary endpoint
- Determinants of symptom and QoL change (AFSS and SF-36)
- Follow-up
- 3 and 12 months postablation
Methodological detailsprespecified analysis
- Prespecified analysis
Primary result
As reported in the abstract
Predictors of symptom/QoL improvement
- SMURDEN correlated with quality of life (QoL) improvement and was the only predictor of no improvement or symptom worsening
- R = 0.31; P < 0.001
- Patients without AF recurrence: greater improvement in most SF-36 and Atrial Fibrillation Symptom Severity (AFSS) subcategories
- P < 0.05
Further findings
| Outcome | PVI | MRI-guided fibrosis ablation | P value |
|---|---|---|---|
| AFSS symptom score, baselineMean | 12.3 (SD 8.2) | 12.0 (SD 8.0) | P = 0.670 |
| AFSS symptom score improvementSymptoms improved in both arms | 6.8 ± 0.5 | 7.3 ± 0.5 | P = 0.114 |
Original publication
Atrial Arrhythmia Burden (SMURDEN) After Ablation of AF Is Associated With Improvement in Quality of Life. JACC Clin Electrophysiol. Published 29 August 2025. doi:10.
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