Kochhäuser Simon, Joza Jacqueline, Essebag Vidal, Proietti Riccardo, Koehler Jodi, Tsang Bernice, Wulffhart Zaev, Pantano Alfredo, Khaykin Yaariv, Ziegler Paul D, Verma Atul
Southlake Regional Health Centre, Newmarket, Canada.
McGill University Health Center, McGill University, Montreal, Canada.
Pacing Clin Electrophysiol. 2016 Feb;39(2):166-72. doi: 10.1111/pace.12772. Epub 2015 Nov 24.
Little is known about the relationship between daily atrial fibrillation (AF) burden and quality of life (QOL). We sought to determine the influence of atrial tachycardia (AT) or AF burden on measures of QOL and symptoms.
We retrospectively analyzed patients with dual-chamber pacemakers from the Atrial Septal Pacing Efficacy Clinical Trial (ASPECT), Atrial Therapy Efficacy and Safety Trial (ATTEST), and aTRial arrhythmias dEtected by implaNted Device diagnostics Study (TRENDS) trials. All patients underwent at least one QOL evaluation. We predefined four AF burden groups: no AT/AF (group 1), ≤30 minutes (group 2), 30 minutes-2 hours (group 3), and >2 hours (group 4) per day. We compared QOL measures using the 12-item Short-Form Health Survey (SF-12; standard 4 week recall) and the AF Symptom Checklist (SC) severity and frequency between groups 2-4 to those in group 1. A total of 798 patients were analyzed (age 72 ± 11 years, 447 male [56%]). SC frequency and severity and SF-12 physical and mental scores worsened significantly when patients in group 4 were compared to patients with no AF. There were no statistically significant differences for any of the measures when comparing group 2 or 3 patients to group 1. By linear regression, only the 2-hour-cutoff had a significant impact on QOL as measured by SC frequency (+3.15, P < 0.001), severity (+3.23, P < 0.001), SF-12 physical score (-2.42, P = 0.013), and SF-12 mental score (-2.11, P = 0.021).
A daily AT/AF burden of more than 2 hours had significant impact on QOL. This might influence the choice of appropriate cut-off points to determine the success of an AF treatment.
关于每日房颤（AF）负荷与生活质量（QOL）之间的关系，人们了解甚少。我们试图确定房性心动过速（AT）或AF负荷对生活质量指标和症状的影响。
我们回顾性分析了来自房间隔起搏疗效临床试验（ASPECT）、心房治疗疗效与安全性试验（ATTEST）以及植入式设备诊断研究检测到的房性心律失常试验（TRENDS）中植入双腔起搏器的患者。所有患者至少接受了一次生活质量评估。我们预先定义了四个AF负荷组：无AT/AF（第1组）、每天≤30分钟（第2组）、30分钟至2小时（第3组）和>2小时（第4组）。我们使用12项简短健康调查问卷（SF-12；标准4周回忆期）以及AF症状清单（SC）的严重程度和频率，比较了第2 - 4组与第1组之间的生活质量指标。总共分析了798例患者（年龄72±11岁，447例男性[56%]）。与无AF的患者相比，第4组患者的SC频率和严重程度以及SF-12身体和心理评分显著恶化。将第2组或第3组患者与第1组患者进行比较时，任何指标均无统计学显著差异。通过线性回归分析，仅2小时的临界值对生活质量有显著影响，具体表现为SC频率（+3.15，P < 0.001））、严重程度（+3.23，P < 0.001）、SF-12身体评分（-2.42，P = 0.013）和SF-12心理评分（-2.11，P = 0.021）。
每日AT/AF负荷超过2小时对生活质量有显著影响。这可能会影响确定AF治疗成功与否的合适临界值的选择。
