Yagishita Atsuhiko, Yamauchi Yasuteru, Sato Hironori, Yamashita Shu, Hirao Tatsuhiko, Miyamoto Takamichi, Hirao Kenzo, Isobe Mitsuaki
Department of Cardiology, Musashino Red Cross Hospital.
Circ J. 2017 Mar 24;81(4):444-449. doi: 10.1253/circj.CJ-16-1123. Epub 2017 Jan 24.
Efficacy of catheter ablation (CA) of asymptomatic persistent atrial fibrillation (AF) remains unclear. We assessed the quality of life (QOL), exercise performance (EP), and plasma B-type natriuretic peptide (BNP) levels following CA in patients with asymptomatic AF.
We enrolled 34 patients with asymptomatic persistent AF. QOL, was assessed by 2 questionnaires: the Short Form-36 (SF-36) and a QOL questionnaire specific for AF (AFQLQ). The QOL, EP, and plasma BNP level were examined before and 6 months after CA. In the SF-36 survey 5 of 8 components and all 3 subsets of the AFQLQ significantly improved in the patients without recurrences (30 patients, 88%), but there were no differences in those with recurrences. In patients without recurrences, there was an increase in the metabolic equivalents of task (10.2±2.3 vs. 11.6±2.3 METs, P<0.0001), duration of maximal exercise (476±144 vs. 605±143 s, P<0.0001), and plasma BNP decrease (146.6±124.3 vs. 33.8±35.6 pg/dL, P<0.0001), with a linear correlation in the increased duration of exercise and plasma BNP decrease (R=0.620, P<0.0001).
Maintenance of sinus rhythm after successful CA improved the QOL, EP, and plasma BNP level in patients with asymptomatic persistent AF. CA may be primarily applicable in such patients with previously unrecognized impairment in their QOL and EP.
无症状持续性房颤(AF)导管消融(CA)的疗效仍不明确。我们评估了无症状房颤患者CA术后的生活质量(QOL)、运动能力(EP)和血浆B型利钠肽(BNP)水平。
我们纳入了34例无症状持续性房颤患者。通过2份问卷评估QOL:简明健康状况调查量表(SF-36)和一份针对房颤的QOL问卷(AFQLQ)。在CA术前及术后6个月检查QOL、EP和血浆BNP水平。在SF-36调查中,无复发的患者(30例,88%)8个组成部分中的5个以及AFQLQ的所有3个子集均有显著改善,但有复发的患者无差异。在无复发的患者中,代谢当量增加(10.2±2.3对11.6±2.3梅脱,P<0.0001),最大运动持续时间增加(476±144对605±143秒,P<0.0001),血浆BNP降低(146.6±124.3对33.8±35.6 pg/dL,P<0.0001),运动持续时间增加与血浆BNP降低呈线性相关(R=0.620,P<0.0001)。
成功CA后窦性心律的维持改善了无症状持续性房颤患者的QOL、EP和血浆BNP水平。CA可能主要适用于那些之前QOL和EP有未被认识到的损害的患者。