Härdén Marie, Nyström Britta, Bengtson Ann, Medin Jennie, Frison Lars, Edvardsson Nils
Division of Cardiology, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
J Interv Card Electrophysiol. 2010 Sep;28(3):185-91. doi: 10.1007/s10840-010-9487-3. Epub 2010 May 12.
To measure the effects on symptoms of electrical cardioversion (DC) in patients with atrial fibrillation (AF) by means of a new, short, validated, AF-specific questionnaire, the AF6.
One hundred eleven patients (67 ± 12 years, 89 men) were screened before and 12 ± 3 days after DC using AF6, covering 'breathing difficulties at rest', 'breathing difficulties on exertion', 'limitations in day-to-day life due to atrial fibrillation', 'feeling of discomfort due to atrial fibrillation', 'tiredness due to atrial fibrillation', and 'worry/anxiety due to atrial fibrillation'. A single global score was calculated. The Toronto AF Symptoms and Severity Check List (AFSS) and the generic SF-36 were also administered. Patients in sinus rhythm at 12 ± 3 days (n = 56) were defined as responders and patients in AF (n = 55) as non-responders.
The mean single global score decreased in all patients (18 ± 12.4 to 13 ± 11.6, p < 0.0001) and in responders (22 ± 14 vs. 12 ± 12, p < 0.01) but not in non-responders (14 ± 9 vs. 14 ± 11, N.S). The AFSS frequency scores decreased from 14.5 ± 7.7 to 9.5 ± 7.8 in responders, p = 0.001, but not in non-responders. There was a strong correlation between changes in the AF6 and the SF-36 regarding four of the six items. Effect sizes of AF6 ranged from 0 to 0.52 in all patients, in responders from 0.10 to 0.85 and in non-responders from -0.23 to 0.34, the highest figures consistently referring to 'tiredness due to atrial fibrillation'.
The symptom scores measured by AF6 decreased significantly, especially in responders. AF6 demonstrated adequate responsiveness to change, and effect sizes were mostly moderate, in responders moderate to high.
通过一种新的、简短的、经过验证的、针对房颤的特定问卷AF6，来测量电复律（直流电）对房颤（AF）患者症状的影响。
111例患者（67±12岁，89例男性）在直流电复律前和复律后12±3天使用AF6进行筛查，该问卷涵盖“静息时呼吸困难”“活动时呼吸困难”“因房颤导致的日常生活受限”“因房颤产生的不适感”“因房颤导致的疲劳”以及“因房颤产生的担忧/焦虑”。计算出一个单一的总体评分。同时还使用了多伦多房颤症状与严重程度检查表（AFSS）和通用的SF-36。在12±3天时处于窦性心律的患者（n = 56）被定义为有反应者，仍处于房颤状态的患者（n = 55）被定义为无反应者。
所有患者的平均单一总体评分均下降（从18±12.4降至13±11.6，p < 0.0001），有反应者的评分也下降（从22±14降至12±12，p < 0.01），但无反应者的评分未下降（从14±9降至14±11，无显著差异）。有反应者的AFSS频率评分从14.5±7.7降至9.5±7.8，p = 0.001，但无反应者的评分未下降。在AF6的变化与SF-36的六项中的四项变化之间存在很强的相关性。AF6在所有患者中的效应大小范围为0至0.52，有反应者为0.10至0.85，无反应者为 -0.23至0.34，最高数值始终与“因房颤导致的疲劳”相关。
AF6测量的症状评分显著下降，尤其是在有反应者中。AF6显示出对变化有足够的反应性，效应大小大多为中等，有反应者为中等至高。
