Department of Cardiology, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China.
Clin Cardiol. 2013 Jan;36(1):40-5. doi: 10.1002/clc.22039. Epub 2012 Jul 9.
Patients with paroxysmal atrial fibrillation (AF) experience impaired quality of life (QoL) and psychological distress. Catheter ablation of AF can markedly improve QoL. However, the effect of catheter ablation of AF on psychological status is unknown.
Depression, anxiety, and QoL improve after catheter ablation in patients with paroxysmal AF.
A total of 166 consecutive patients with symptomatic paroxysmal AF were examined. Eighty-two patients (55 men, mean age 55.9 ± 6.1 y) underwent catheter ablation and 84 patients (58 men, mean age 57.2 ± 5.4 years) received antiarrhythmic drug (AAD) therapy. The Self-Rating Depression Scale, Self-Rating Anxiety Scale, and Medical Outcomes Survey 36-item Short-Form questionnaires were completed by these patients at baseline, and at 3, 6, 9, and 12 months of follow-up. Results in the ablation group were compared with those of the AAD group.
In the ablation group, 42.7% of patients showed symptoms of depression and 37.8% showed symptoms of anxiety, which were similar to those in the AAD group. Both groups similarly displayed reduced physical and mental QoL. Catheter ablation was effective in reducing symptoms of depression and anxiety and improving QoL, and it was superior to AAD therapy (all P < 0.001). Multiple regression analysis demonstrated that catheter ablation, no AF recurrence, avoidance of warfarin use, higher baseline depression and anxiety scores, and lower baseline QoL scores contributed to improvement of depression, anxiety, and QoL, respectively.
Catheter ablation is more effective for improving depression, anxiety, and QoL in patients with paroxysmal AF compared with AAD therapy.
阵发性心房颤动（AF）患者的生活质量（QoL）和心理困扰受损。导管消融 AF 可显著改善 QoL。然而，导管消融 AF 对心理状态的影响尚不清楚。
阵发性 AF 患者导管消融后抑郁、焦虑和 QoL 改善。
共检查了 166 例有症状的阵发性 AF 连续患者。82 例患者（55 例男性，平均年龄 55.9±6.1 岁）接受导管消融治疗，84 例患者（58 例男性，平均年龄 57.2±5.4 岁）接受抗心律失常药物（AAD）治疗。这些患者在基线时以及随访 3、6、9 和 12 个月时完成了自评抑郁量表、自评焦虑量表和医疗结局研究 36 项简短调查问卷。消融组的结果与 AAD 组进行了比较。
在消融组中，42.7%的患者有抑郁症状，37.8%的患者有焦虑症状，与 AAD 组相似。两组患者的身体和精神 QoL 均下降。导管消融可有效减轻抑郁和焦虑症状，改善 QoL，优于 AAD 治疗（均 P<0.001）。多元回归分析表明，导管消融、无 AF 复发、避免使用华法林、较高的基线抑郁和焦虑评分以及较低的基线 QoL 评分分别有助于改善抑郁、焦虑和 QoL。
与 AAD 治疗相比，导管消融更有效地改善阵发性 AF 患者的抑郁、焦虑和 QoL。
