Woźniak-Skowerska Iwona M, Skowerski Mariusz J, Hoffmann Andrzej, Nowak Seweryn, Faryan Maciej, Kolasa Jarosław, Skowerski Tomasz, Szydło Krzysztof, Wnuk-Wojnar Anna Maria, Mizia-Stec Katarzyna
I Oddział Kardiologii SPSK nr 7 Katowice 40-635 ul Ziolowa 45/47.
Kardiol Pol. 2016;74(3):244-50. doi: 10.5603/KP.a2015.0160. Epub 2015 Aug 25.
Atrial fibrillation (AF) is the most common arrhythmia and is associated with a deterioration of quality of life (QoL). Catheter ablation is a therapeutic strategy for some patients with AF. The effectiveness of pulmonary vein isolation is still under assessment.
To assess the long-term influence of circumferential pulmonary vein ablation (CPVA) on QoL in patients with AF.
The study population consisted of 33 patients (26 males, age 54.2 ± 9 years) with highly symptomatic (EHRA II-III) drug refractory paroxysmal AF, who underwent CPVA. A clinical examination, electrocardiogram (ECG), and Holter ECG were performed before and during a one-year follow-up. The SF-36 Medical Outcomes Survey Short-Form QoL questionnaire, scored on a 0-100 scale for each of eight domains: bodily pain (BP), general health (GH), mental health (MH), physical functioning (PF), role-emotional (RE), role-physical (RP), social functioning (SF), and vitality (V), was collected before and one year after CPVA.
In the one-year follow-up 27 (82%) patients were free of AF. EHRA symptoms were improved one-year after CPVA regardless of CPVA efficacy. After the follow-up the SF-36 questionnaire results improved significantly in all of the subscales in patients without a recurrence of AF after CPVA. In subjects with a recurrence of AF, all of the subscales did not indicate any statistically significant differences. There was an association between the CPVA and the following QoL domains: GH (p = 0.018), PF (p = 0.042), and V (p = 0.041). The highest values of the GH and V domains were found in the non-recurrence patients one year after CPVA.
CPVA results in the clinical improvement of patients with symptomatic AF regardless of the final arrhythmia termination. Patients after successful CPVA experienced a significant improvement in all of the subscales of the QoL.
心房颤动（AF）是最常见的心律失常，与生活质量（QoL）下降相关。导管消融是部分房颤患者的一种治疗策略。肺静脉隔离的有效性仍在评估中。
评估环肺静脉消融（CPVA）对房颤患者生活质量的长期影响。
研究人群包括33例（26例男性，年龄54.2±9岁）症状严重（欧洲心律协会（EHRA）II-III级）、药物难治性阵发性房颤患者，这些患者接受了CPVA。在一年随访期之前及随访期间进行了临床检查、心电图（ECG）和动态心电图检查。收集了CPVA术前及术后一年的SF-36简明健康状况调查问卷结果，该问卷在八个领域（身体疼痛（BP）、总体健康（GH）、心理健康（MH）、身体功能（PF）、情感角色（RE）、身体角色（RP）、社会功能（SF）和活力（V））中每个领域的评分范围为0至100分。
在一年随访期内，27例（82%）患者无房颤发作。无论CPVA疗效如何，CPVA术后一年EHRA症状均有所改善。随访后，CPVA术后无房颤复发患者的所有子量表中，SF-36问卷结果均有显著改善。在房颤复发的患者中，所有子量表均未显示出任何统计学上的显著差异。CPVA与以下生活质量领域之间存在关联：总体健康（p = 0.018）、身体功能（p = 0.042）和活力（p = 0.041）。在CPVA术后一年，总体健康和活力领域的最高得分出现在无复发患者中。
无论最终心律失常是否终止，CPVA均可使有症状房颤患者的临床症状得到改善。成功接受CPVA的患者在生活质量的所有子量表中均有显著改善。
