Yamamoto Mayumi, Watanabe Eiichi, Suzuki Takeki, Yamazaki Tsutomu, Ohtsu Hiroshi, Ozaki Yukio, Ogawa Satoshi, Yamashita Takeshi
Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan.
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
J Cardiol. 2014 Jul;64(1):64-9. doi: 10.1016/j.jjcc.2013.11.011. Epub 2013 Dec 25.
Paroxysmal atrial fibrillation (AF) patients have a reduced quality-of-life (QoL) despite the fact that the majority of AF episodes are asymptomatic. Asymptomatic AF is likely to be associated with substantial morbidity and mortality rates similar to those with symptomatic AF, whereas its effect on the QoL has not yet been clarified.
We studied the specific contribution of asymptomatic AF episodes to reducing the QoL.
We assessed the QoL in 233 patients with paroxysmal AF and hypertension (age 64.9 ± 9.7 years, 71% male) enrolled in the Japanese Rhythm Management Trial II for Atrial Fibrillation (J-RHYTHM II study) using an AF-specific QoL questionnaire (AFQLQ). The AFQLQ comprised 3 components: AFQLQ1, the frequency and duration of symptoms; AFQLQ2, severity of symptoms; and AFQLQ3, limitations in daily activities and mental anxiety. Higher scores indicated a better QoL. Each patient transmitted electrocardiograms for 30s daily at a predetermined time as well as whenever arrhythmia-related symptoms were experienced. We examined the relationship between the 3 AFQLQ components and frequency of symptomatic and asymptomatic AF episodes (days/month) during 12 months of follow-up.
The symptomatic and asymptomatic AF frequencies were 0.9 ± 3.1 days/month and 1.5 ± 3.5 days/month, respectively. AFQLQ1 negatively correlated with the symptomatic AF frequency (Spearman's correlation coefficient: r = -0.332, p < 0.001). AFQLQ2 and AFQLQ3 correlated with both the symptomatic AF frequency (r = -0.27, p < 0.001 and r = -0.265, p < 0.001, respectively) and asymptomatic AF frequency (r = -0.197, p < 0.01 and r = -0.229, p < 0.005, respectively).
The asymptomatic AF episode frequency correlates with a reduced QoL in patients with paroxysmal AF, suggesting that there would be psychological benefits to its reduction.
尽管大多数阵发性房颤（AF）发作是无症状的，但阵发性房颤患者的生活质量（QoL）仍有所下降。无症状性房颤可能与有症状性房颤相似的高发病率和死亡率相关，但其对生活质量的影响尚未阐明。
我们研究了无症状性房颤发作对降低生活质量的具体影响。
我们使用房颤特异性生活质量问卷（AFQLQ）对纳入日本房颤节律管理试验II（J-RHYTHM II研究）的233例阵发性房颤合并高血压患者（年龄64.9±9.7岁，71%为男性）的生活质量进行了评估。AFQLQ包括3个部分：AFQLQ1，症状的频率和持续时间；AFQLQ2，症状的严重程度；AFQLQ3，日常活动受限和精神焦虑。分数越高表明生活质量越好。每位患者每天在预定时间以及出现心律失常相关症状时传输30秒心电图。我们研究了随访12个月期间AFQLQ的3个部分与有症状和无症状房颤发作频率（天/月）之间的关系。
有症状和无症状房颤的频率分别为0.9±3.1天/月和1.5±3.5天/月。AFQLQ1与有症状房颤频率呈负相关（斯皮尔曼相关系数：r = -0.332，p < 0.001）。AFQLQ2和AFQLQ3与有症状房颤频率（分别为r = -0.27，p < 0.001和r = -0.265，p < 0.001）以及无症状房颤频率（分别为r = -0.197，p < 0.01和r = -0.229，p < 0.005）均相关。
无症状性房颤发作频率与阵发性房颤患者生活质量降低相关，提示减少无症状性房颤发作可能对心理有益。
