Singh Steven N, Tang X Charlene, Singh Bramah N, Dorian Paul, Reda Domenic J, Harris Crystal L, Fletcher Ross D, Sharma Satish C, Atwood J Edwin, Jacobson Alan K, Lewis H Daniel, Lopez Becky, Raisch Dennis W, Ezekowitz Michael D
Department of Veterans Affairs Medical Center, Washington, DC 20422, USA.
J Am Coll Cardiol. 2006 Aug 15;48(4):721-30. doi: 10.1016/j.jacc.2006.03.051. Epub 2006 Jul 24.
The purpose of this study was to determine quality of life (QOL) and exercise performance (EP) in patients with persistent atrial fibrillation (AF) converted to sinus rhythm (SR) compared with those remaining in or reverting to AF.
Restoration of SR in patients with AF improving QOL and EP remains controversial.
Patients with persistent AF were randomized double-blind to amiodarone, sotalol, or placebo. Those not achieving SR at day 28 were cardioverted and classified into SR or AF groups at 8 weeks (n = 624) and 1 year (n = 556). The QOL (SF-36), symptom checklist (SCL), specific activity scale (SAS), AF severity scale (AFSS), and EP were assessed.
Favorable changes were seen in SR patients at 8 weeks in physical functioning (p < 0.001), physical role limitations (p = 0.03), general health (p = 0.002), and vitality (p < 0.001), and at 1 year in general health (p = 0.007) and social functioning (p = 0.02). Changes in the scores for SCL severity (p = 0.01), functional capacity (p = 0.003), and AFSS symptom burden (p < 0.001) at 8 weeks and in SCL severity (p < 0.01) and AF symptom burden (p < 0.001) at 1 year showed significant improvements in SR versus AF. Symptomatic patients were more likely to have improvement. The EP in SR versus AF was greater from baseline to 8 weeks (p = 0.01) and to 1 year (p = 0.02). The EP correlated with physical functioning and functional capacity except in the AF group at 1 year.
In patients with persistent AF, restoration and maintenance of SR was associated with improvements in QOL measures and EP. There was a strong correlation between QOL measures and EP.
本研究旨在确定持续性房颤（AF）转为窦性心律（SR）的患者与仍处于房颤或房颤复发患者的生活质量（QOL）和运动表现（EP）。
房颤患者恢复窦性心律能否改善生活质量和运动表现仍存在争议。
持续性房颤患者被随机双盲分为接受胺碘酮、索他洛尔或安慰剂治疗。在第28天未实现窦性心律的患者进行心脏复律，并在8周（n = 624）和1年（n = 556）时分为窦性心律组或房颤组。评估生活质量（SF - 36）、症状清单（SCL）、特定活动量表（SAS）、房颤严重程度量表（AFSS）和运动表现。
窦性心律组患者在8周时身体功能（p < 0.001）、身体角色限制（p = 0.03）、总体健康（p = 0.002）和活力（p < 0.001）方面有良好变化，在1年时总体健康（p = 0.007）和社会功能（p = 0.02）方面有良好变化。窦性心律组与房颤组相比，8周时SCL严重程度评分（p = 0.01）、功能能力评分（p = 0.003）和AFSS症状负担评分（p < 0.001）以及1年时SCL严重程度评分（p < 0.01）和房颤症状负担评分（p < 0.001）均有显著改善。有症状的患者更有可能得到改善。从基线到8周（p = 0.01）和到1年（p = 0.02），窦性心律组与房颤组相比运动表现更佳。除1年时房颤组外，运动表现与身体功能和功能能力相关。
在持续性房颤患者中，窦性心律的恢复和维持与生活质量指标和运动表现的改善相关。生活质量指标与运动表现之间存在强相关性。
