Socioeconomic status does not influence quality of life and mood outcomes after catheter ablation for atrial fibrillation: A call for equitable access.

Background: Previous studies indicate that socioeconomic status (SES) is a determinant of successful rhythm control in atrial fibrillation (AF). However, data relating specifically to ablation outcomes are lacking. Objective: We sought to investigate the relationship between SES and AF ablation outcomes. Methods: Participants enrolled in 2 multicenter randomized trials evaluating AF ablation outcomes were invited to participate in an SES survey. SES indicators collected included cultural and linguistic diversity, education, occupational skill, weekly income, and the Household, Income and Labour Dynamics in Australia index of social support. The impact of SES on AF-related quality of life (QoL) (primary outcome) and mood was evaluated with regression methods. Results: 159 patients provided consent and answers to the SES survey. The mean age was 62.8 ± 9.4 years, and 78% were male. In this cohort, 56.6% were treated in a public hospital; 40% completed a certificate, diploma, or degree; and 40% were in a highly skilled occupation. The interquartile range of weekly income was $850-$2307. Median social support index was 59/70. Principal component analysis divided the cohort into SES quartiles. Mean 12-month change in standardized QoL score was 22.4 ± 30.4 (maximum score 100). There was a reduction in the 12-month anxiety/depression score of -4.8 ± 7.01 (maximum score 21). Median AF burden was 0% (0%-1.9%). These changes did not differ across SES quartiles. Conclusion: Across a wide spectrum of SES, AF ablation was highly effective for improvements in AF-related QoL and anxiety/depression. These improvements correlated with low AF burden after ablation.