Quality of life and recurrent healthcare use remain important concerns after atrial fibrillation (AF) ablation. The NURSECAT-AF trial assessed the effectiveness of an integrated nurse-led care (NLC) model in patients undergoing first-time AF ablation. This single-center, prospective, randomized clinical trial, published in Circulation: Arrhythmia and Electrophysiology, enrolled consecutive patients without heart failure (HF) who were referred for initial AF ablation and assigned them to NLC or usual care.

The NLC intervention included an AF-focused educational program, peri-procedural support, and structured risk factor management. Scheduled visits were conducted at 15 days before ablation, and at 15 days and 6 months after the procedure. A total of 116 individuals were screened, with 66 randomized equally between groups (mean age 63±10 years; 67% male). 

The primary end point was quality of life (QoL) at 12 months postablation, assessed using the arrhythmia-specific scale in tachycardia and arrhythmia (ASTA). At 1 year, NLC showed a statistically significant improvement in QoL compared with usual care (baseline-adjusted ASTA difference +4 points; 95% CI, 1.8-6.3; P=0.0007).

Secondary outcomes also favored NLC, including lower odds of arrhythmia recurrence (odds ratio [OR], 0.2; 95% CI, 0.05-0.78) and emergency visits (OR, 0.2; 95% CI, 0.06-0.66). Lower symptom burden, higher patient satisfaction, and greater knowledge of AF-related issues were also observed at follow-up. Risk factor profiles improved in the NLC group, including higher rates of smoking cessation, regular physical activity, and weight optimization. Detection of obstructive sleep apnea was also more frequent with NLC.

These findings indicate that structured NLC improved quality of life, reduced arrhythmia recurrence and emergency visits, and supported risk factor management after AF ablation. The results support integration of nurse-led intervention into the peri-ablation care pathway.