EHRA scores are used to discriminate symptoms severity when patients feel they are in AF. However, patients still complain of disabling symptoms when they are in constant sinus rhythm post AF ablation. What is the validity of using EHRA score post procedural when the patient's general condition due to other comorbidities is restricted (arthritis, COPD, asthma, etc) while they are in sinus rhythm all the time?
EHRA is a simple functional gradation much like the NYHA or Canadian angina classes that aimed, first of all to measure patient's need in specific treatment (actually to measure possible benefit that may be achieved with the treatment in the terms of score reduction). This is necessary to put decision-making about the treatment on a firm foundation of quantitative risk-benefit analysis. In order words, the EHRA is a tool to objectify decision-making and rationalise administration of the treatment. If the treatment is not in question (sinus rhythm) then there is no need in specific tool to justify its administration. Also, if the disability is caused by other pathology than rhythm disorder then each of such pathology has its own functional scale that should be used.
I am not an arrhythmologist (I am a general cardiologist), but in my opinion, the EHRA score can be used for assessement AF related symptoms and to queality of life after ablation. therefore, maybe pre and post ablation EHRA score is useful for detection of effectiveness of the procedure.
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