Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway.
Scand Cardiovasc J. 2010 Jun;44(3):132-8. doi: 10.3109/14017430903552632.
The AHA/ACC/ESC Guidelines for management of atrial fibrillation (AF) patients suggest criteria for adequate rate control. We hypothesized that AF patients fulfilling these criteria would have better quality of life (QoL) and exercise capacity compared to the ones not fulfilling the criteria.
Heart rate at rest, during moderate exercise and over 24 hours, and peak oxygen uptake (VO(2) peak) were measured in patients with permanent AF, all aged 75 years, recruited from two Norwegian municipalities. SF-36 Physical component summary (PCS) and Mental component summary (MCS) QoL scores were assessed. The similar program was also applied to 71 age-matched subjects in sinus rhythm.
Twenty-seven AF patients participated. Six (22%) of the AF patients satisfied the Guidelines' criteria for rate control; their VO(2) peak (mean +/- SD) was 23.0 +/- 6.5 versus 22.6 +/- 5.3 ml/kg/min in AF patients not satisfying the criteria, PCS score had median (25(th), 75(th) percentile) 44 (30, 57) versus 41 (31, 47), and MCS score had median 52 (40, 62) versus 56 (43, 60), all p-values > 0.500. When the rate criteria were applied to the group in sinus rhythm, only 45% had heart rates within the ranges recommended by the Guidelines for AF patients.
AF patients satisfying the Guidelines' criteria for adequate rate control did not have higher oxygen uptake or report better QoL than AF patients not satisfying the criteria.
美国心脏协会/美国心脏病学会/欧洲心脏病学会（AHA/ACC/ESC）心房颤动（AF）患者管理指南建议了适当的心率控制标准。我们假设，满足这些标准的 AF 患者的生活质量（QoL）和运动能力会优于不满足标准的患者。
在两个挪威自治市招募的所有 75 岁的永久性 AF 患者中，测量了静息时、中度运动时和 24 小时内心率以及峰值摄氧量（VO2 峰值），并评估了 SF-36 身体成分综合评分（PCS）和精神成分综合评分（MCS）的 QoL 评分。同样的程序也应用于 71 名年龄匹配的窦性节律患者。
27 名 AF 患者参与了研究。6 名（22%）AF 患者满足指南中对心率控制的标准；他们的 VO2 峰值（平均值±标准差）为 23.0±6.5ml/kg/min，而不满足标准的 AF 患者为 22.6±5.3ml/kg/min，PCS 评分中位数（25%，75%分位数）为 44（30，57）与 41（31，47），MCS 评分中位数为 52（40，62）与 56（43，60），所有 p 值均>0.500。当将这些心率标准应用于窦性节律组时，仅有 45%的患者的心率在 AF 患者指南推荐的范围内。
满足指南中适当心率控制标准的 AF 患者的摄氧量并没有更高，或报告的 QoL 并没有优于不满足标准的患者。
