生活质量、焦虑和抑郁与左心房消融术结果的关联。
Association of quality of life, anxiety, and depression with left atrial ablation outcomes.
作者信息
Efremidis Michael, Letsas Konstantinos P, Lioni Louiza, Giannopoulos Georgios, Korantzopoulos Panagiotis, Vlachos Konstantinos, Dimopoulos Nikolaos P, Karlis Dimitrios, Bouras Georgios, Sideris Antonios, Deftereos Spyridon
机构信息
Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Athens, Greece.
出版信息
Pacing Clin Electrophysiol. 2014 Jun;37(6):703-11. doi: 10.1111/pace.12420. Epub 2014 May 9.
BACKGROUND
Atrial fibrillation (AF) is associated with significant impairment of quality of life (QoL). Anxiety and depression are common in AF patients and might predispose to AF. We sought to investigate associations of preablative QoL and stress parameters with AF ablation outcomes, as well as possible changes in QoL, anxiety, and depression parameters after ablation.
METHODS
A total of 57 consecutive patients with paroxysmal AF underwent pulmonary vein (PV) antral isolation. The Short-Form Life Survey-36 items (SF-36), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI) were assessed before and at 6 months after ablation.
RESULTS
After a mean follow-up of 8.0 ± 2.5 months, 41 patients (71.9%) remained free from arrhythmia. Baseline mental health summary QoL SF-36 score was significantly lower in patients with AF recurrence (53.2 ± 10.3 vs 69.7 ± 17.9; P = 0.001), while the physical health summary score did not differ significantly between patients with and without recurrence. Patients with recurrence had higher baseline STAI-trait (41.9 ± 1.5 vs 34.7 ± 4.9) and BDI (17.3 ± 9.7 vs 5.4 ± 3.0) scores (P < 0.001 for both). In multivariable analysis, SF-36 mental health summary, STAI-trait, and BDI scores remained significant predictors of recurrence after adjustment for age, gender, body mass index, diabetes, and hypertension. Mental and physical domain SF-36 summary scores were significantly improved 6 months after ablation (P = 0.001) and a significant reduction in symptoms of depression (P = 0.001) and anxiety (P = 0.001) was observed.
CONCLUSIONS
Baseline QoL, anxiety, and depression metrics were associated with AF recurrence following PV antral isolation. Furthermore, there was a significant improvement in QoL, anxiety, and depression after left atrial ablation.
背景
心房颤动(AF)与生活质量(QoL)的显著受损相关。焦虑和抑郁在AF患者中很常见,并且可能易患AF。我们试图研究消融术前的QoL和应激参数与AF消融结果之间的关联,以及消融后QoL、焦虑和抑郁参数可能发生的变化。
方法
总共57例连续性阵发性AF患者接受了肺静脉(PV)前庭隔离术。在消融术前和术后6个月评估简短生命调查-36项问卷(SF-36)、状态-特质焦虑量表(STAI)和贝克抑郁量表(BDI)。
结果
平均随访8.0±2.5个月后,41例患者(71.9%)未再发生心律失常。AF复发患者的基线心理健康总结QoL SF-36评分显著更低(53.2±10.3对69.7±17.9;P = 0.001),而有复发和无复发患者的身体健康总结评分无显著差异。复发患者的基线STAI-特质评分(41.9±1.5对34.7±4.9)和BDI评分(17.3±9.7对5.4±3.0)更高(两者P均<0.001)。在多变量分析中,调整年龄性别、体重指数、糖尿病和高血压后,SF-36心理健康总结、STAI-特质和BDI评分仍是复发的显著预测因素。消融术后6个月,精神和身体领域的SF-36总结评分显著改善(P = 0.001),并且观察到抑郁症状(P = 0.001)和焦虑症状(P = 0.001)显著减轻。
结论
基线QoL、焦虑和抑郁指标与PV前庭隔离术后的AF复发相关。此外,左心房消融术后QoL、焦虑和抑郁有显著改善。