Montreal Heart Institute, Université de Montréal, Montreal, Canada.
KU Leuven Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.
Heart Rhythm. 2021 May;18(5):793-800. doi: 10.1016/j.hrthm.2020.09.012. Epub 2020 Sep 19.
Atrial arrhythmias (ie, intra-atrial reentrant tachycardia and atrial fibrillation) are a leading cause of morbidity and hospitalization in adults with congenital heart disease (CHD). Little is known about their effect on quality of life and other patient-reported outcomes (PROs) in adults with CHD.
The purpose of this study was to assess the impact of atrial arrhythmias on PROs in adults with CHD and explore geographic variations.
Associations between atrial arrhythmias and PROs were assessed in a cross-sectional study of adults with CHD from 15 countries spanning 5 continents. A propensity-based matching weight analysis was performed to compare quality of life, perceived health status, psychological distress, sense of coherence, and illness perception in patients with and those without atrial arrhythmias.
A total of 4028 adults with CHD were enrolled, 707 (17.6%) of whom had atrial arrhythmias. After applying matching weights, patients with and those without atrial arrhythmias were comparable with regard to age (mean 40.1 vs 40.2 years), demographic variables (52.5% vs 52.2% women), and complexity of CHD (15.9% simple, 44.8% moderate, and 39.2% complex in both groups). Patients with atrial arrhythmias had significantly worse PRO scores with respect to quality of life, perceived health status, psychological distress (ie, depression), and illness perception. A summary score that combines all PRO measures was significantly lower in patients with atrial arrhythmias (-3.3%; P = .0006). Differences in PROs were consistent across geographic regions.
Atrial arrhythmias in adults with CHD are associated with an adverse impact on a broad range of PROs consistently across various geographic regions.
房性心律失常（即房内折返性心动过速和心房颤动）是导致成人先天性心脏病（CHD）发病率和住院率高的主要原因。对于其对 CHD 成人生活质量和其他患者报告结局（PRO）的影响，我们知之甚少。
本研究旨在评估房性心律失常对 CHD 成人 PRO 的影响，并探讨地域差异。
在一项涵盖五大洲 15 个国家的 CHD 成人的横断面研究中，评估了房性心律失常与 PRO 之间的关联。采用基于倾向的匹配权重分析比较了有房性心律失常和无房性心律失常患者的生活质量、感知健康状况、心理困扰、心理一致感和疾病感知。
共纳入 4028 例 CHD 成人，其中 707 例（17.6%）患有房性心律失常。应用匹配权重后，有房性心律失常和无房性心律失常的患者在年龄（平均年龄 40.1 岁比 40.2 岁）、人口统计学变量（52.5%比 52.2%女性）和 CHD 复杂性（两组中 15.9%为简单、44.8%为中度、39.2%为复杂）方面具有可比性。有房性心律失常的患者在生活质量、感知健康状况、心理困扰（即抑郁）和疾病感知方面的 PRO 评分明显更差。有房性心律失常患者的所有 PRO 测量综合评分明显更低（-3.3%；P=0.0006）。PRO 差异在不同地理区域是一致的。
CHD 成人中的房性心律失常与广泛的 PRO 不良影响相关，且在不同地理区域均一致。
