Patients' experiences 1-6 months after atrial fibrillation ablation: An holistic perspective

J Adv Nurs. 2019 Jan;75(1):150-160. doi: 10.1111/jan.13843. Epub 2018 Oct 5.

Abstract

Aim: To describe patients' experiences from a holistic perspective 1-6 months after atrial fibrillation (AF) ablation.

Background: Catheter ablation (CA) is an invasive treatment for AF. While CA has Class 1A indication, the latest guidelines for AF management state there is an urgent need to better understand complications in clinical practice to improve the quality of AF ablation procedures.

Design: A qualitative analytic approach based on a deductive and descriptive design was used.

Methods: Interviews of 19 patients, carried out from September 2016 to February 2017, were analysed using qualitative content analysis.

Findings: Five themes were identified; one in each life dimension due to the deductive design based on a holistic model: (a) having unexpected complications with a slower recovery; (b) discovering one's own self-management strategies when lacking information and insufficient follow-up; (c) managing resentment through different coping strategies while emotional reactions depended on feeling better or worse; (d) failing to receive full understanding and support from close ones, with social consequences when the biophysical level did not return to normal; (e) gradually adopting new life perspectives with a hope for a better future, despite having unmet expectations and uncertainty, leading to discovering existential matters.

Conclusion: Patients' post CA experiences could be understood in terms of a holistic model. Their feelings of uncertainty caused by a lack of medical follow-up led to emotional reactions, the magnitude of which depended on feeling-well or worse. Patients' need more information about possible complications, suggesting follow-up and patient education needs improvement.

Keywords: arrhythmia; catheter ablation; electrophysiology; holistic model; interview; nursing; patients’ experiences; qualitative analysis; whole person.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Atrial Fibrillation / psychology*
  • Atrial Fibrillation / surgery*
  • Catheter Ablation / psychology*
  • Female
  • Follow-Up Studies
  • Holistic Health
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction*
  • Qualitative Research
  • Quality of Life / psychology*