Dorian Paul, Cvitkovic Suzan S, Kerr Charles R, Crystal Eugene, Gillis Anne M, Guerra Peter G, Mitchell L Brent, Roy Denis, Skanes Allan C, Wyse D George
Division of Cardiology, St. Michael's Hospital, University of Toronto, Ontario, Canada.
Can J Cardiol. 2006 Apr;22(5):383-6. doi: 10.1016/s0828-282x(06)70922-9.
The severity of symptoms caused by atrial fibrillation (AF) is extremely variable. Quantifying the effect of AF on patient well-being is important but there is no simple, commonly accepted measure of the effect of AF on quality of life (QoL). Current QoL measures are cumbersome and impractical for clinical use.
To create a simple, concise and readily usable AF severity score to facilitate treatment decisions and physician communication.
The Canadian Cardiovascular Society (CCS) Severity of Atrial Fibrillation (SAF) Scale is analogous to the CCS Angina Functional Class. The CCS-SAF score is determined using three steps: documentation of possible AF-related symptoms (palpitations, dyspnea, dizziness/syncope, chest pain, weakness/fatigue); determination of symptom-rhythm correlation; and assessment of the effect of these symptoms on patient daily function and QoL. CCS-SAF scores range from 0 (asymptomatic) to 4 (severe impact of symptoms on QoL and activities of daily living). Patients are also categorized by type of AF (paroxysmal versus persistent/permanent). The CCS-SAF Scale will be validated using accepted measures of patient-perceived severity of symptoms and impairment of QoL and will require 'field testing' to ensure its applicability and reproducibility in the clinical setting.
This type of symptom severity scale, like the New York Heart Association Functional Class for heart failure symptoms and the CCS Functional Class for angina symptoms, trades precision and comprehensiveness for simplicity and ease of use at the bedside. A common language to quantify AF severity may help to improve patient care.
心房颤动（AF）所引起症状的严重程度差异极大。量化AF对患者健康状况的影响十分重要，但目前尚无一种简单且被广泛接受的衡量AF对生活质量（QoL）影响的方法。当前的QoL测量方法繁琐且不适合临床应用。
创建一个简单、简洁且易于使用的AF严重程度评分，以辅助治疗决策及医生之间的沟通。
加拿大心血管学会（CCS）心房颤动严重程度（SAF）量表类似于CCS心绞痛功能分级。CCS-SAF评分通过三个步骤确定：记录可能与AF相关的症状（心悸、呼吸困难、头晕/晕厥、胸痛、虚弱/疲劳）；确定症状与节律的相关性；评估这些症状对患者日常功能和QoL的影响。CCS-SAF评分范围从0（无症状）到4（症状对QoL和日常生活活动有严重影响）。患者还按AF类型（阵发性与持续性/永久性）进行分类。CCS-SAF量表将使用公认的患者感知症状严重程度和QoL受损程度的测量方法进行验证，并且需要进行“现场测试”以确保其在临床环境中的适用性和可重复性。
这种症状严重程度量表，如同用于心力衰竭症状的纽约心脏协会功能分级以及用于心绞痛症状的CCS功能分级一样，以牺牲精确性和全面性为代价，换取了床边使用的简单性和便利性。一种量化AF严重程度的通用语言可能有助于改善患者护理。
