Kato Masaru, Miake Junichiro, Ogura Kazuyoshi, Iitsuka Kazuhiko, Okamura Akihiro, Tomomori Takuya, Tsujimoto Daiki, Kato Masahiko, Yamamoto Kazuhiro
Division of Cardiovascular Medicine, Endocrinology and Metabolism, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University.
Int Heart J. 2019 Nov 30;60(6):1328-1333. doi: 10.1536/ihj.19-201. Epub 2019 Nov 15.
The effect of restoring sinus rhythm by pulmonary vein isolation (PVI) on the quality of life (QOL) of patients with persistent atrial fibrillation (PerAF) has not been adequately investigated. This study was performed to compare the changes in QOL after extended PVI between patients with PerAF and paroxysmal AF (PAF).Patients with PAF (n = 38) and PerAF (n = 22) who underwent their first PVI and developed no AF recurrence 6 months after PVI were enrolled. QOL surveys were performed at baseline and 6 months post-ablation using Short Form-36 surveys.The mental component summary score (MCS) (53.4 ± 10.2 to 56.5 ± 7.1, P = 0.019) and physical component summary score (PCS) (46.1 ± 10.6 to 48.5 ± 8.3, P = 0.015) improved after PVI in the PAF group. The PCS, but not the MCS, improved after PVI in the PerAF group (45.8 ± 7.9 to 51.5 ± 6.2, P < 0.001). Changes in the PCS were greater in the PerAF group than in the PAF group (8.6 ± 6.9 versus 2.8 ± 5.2, P = 0.009). Multivariate regression analysis demonstrated that a low baseline MCS and the type of AF (PAF) were independent predictors of an increased MCS and that a low baseline PCS and the type of AF (PerAF) were independent predictors of an increased PCS.The changes in QOL differed between PAF and PerAF after PVI. Although most patients with PerAF were asymptomatic before PVI, their improvement in physical QOL was greater than that in patients with PAF. Such beneficial effects on physical QOL are likely expected in patients with PerAF with a low PCS before PVI.
肺静脉隔离（PVI）恢复窦性心律对持续性心房颤动（PerAF）患者生活质量（QOL）的影响尚未得到充分研究。本研究旨在比较持续性房颤患者和阵发性房颤（PAF）患者在扩大PVI术后生活质量的变化。纳入首次接受PVI且术后6个月无房颤复发的PAF患者（n = 38）和PerAF患者（n = 22）。在基线和消融术后6个月使用简短健康调查问卷进行生活质量调查。PAF组在PVI术后精神健康综合评分（MCS）（从53.4±10.2提高到56.5±7.1，P = 0.019）和生理健康综合评分（PCS）（从46.1±10.6提高到48.5±8.3，P = 0.015）有所改善。PerAF组在PVI术后PCS有所改善，但MCS未改善（从45.8±7.9提高到51.5±6.2，P < 0.001）。PerAF组PCS的变化大于PAF组（8.6±6.9对比2.8±5.2，P = 0.009）。多因素回归分析表明，低基线MCS和房颤类型（PAF）是MCS升高的独立预测因素，低基线PCS和房颤类型（PerAF）是PCS升高的独立预测因素。PVI术后PAF和PerAF的生活质量变化有所不同。尽管大多数PerAF患者在PVI术前无症状，但他们在生理生活质量方面的改善大于PAF患者。对于术前PCS较低的PerAF患者，可能预期对其生理生活质量有此类有益影响。
