J Cardiovasc Nurs. 2023;38(2):E78-E86. doi: 10.1097/JCN.0000000000000909. Epub 2022 Apr 6.
Poor sleep quality is highly prevalent in atrial fibrillation (AF) with reported links between worse sleep quality and higher AF severity. Little research has examined whether sleep quality changes after AF ablation despite it being a routinely performed procedure.
The aim of this study was to evaluate self-reported sleep quality before and after AF ablation and to examine whether sleep quality differs by AF severity or sex.
This longitudinal pilot study assessed sleep using the Pittsburgh Sleep Quality Index at preablation and at 1, 3, and 6 months after ablation. Atrial fibrillation disease severity was assessed by the Canadian Cardiology Society Severity of AF scale. Outcomes were analyzed using descriptive statistics, Spearman ρ correlations, and multilevel longitudinal models.
The sample (N = 20) was 55% female with a mean age of 65 (±7) years. Poor sleep quality (mean Pittsburgh Sleep Quality Index scores > 5) was evident at all time points. Improvement was noted at 3 months (moderate effect size d = 0.49); and negligible further improvement, from 3 to 6 months post ablation. Improvement was seen primarily in male subjects (large effect size d = 0.89 at 3 months), with smaller improvements for female subjects. Although Severity of AF scale scores were not correlated with sleep quality, Severity of AF scale severity scores did significantly improve over time.
Patients with AF have poor sleep quality that improves for the first 3 months after AF ablation, with men showing more improvement than women. A more accurate understanding of the sleep challenges after AF ablation could lead to development of more realistic patient education and improve patient self-management.
心房颤动(AF)患者的睡眠质量较差,且睡眠质量与 AF 严重程度之间存在相关性。尽管消融术是一种常规治疗方法,但很少有研究探讨 AF 消融术后睡眠质量是否会发生变化。
本研究旨在评估 AF 消融术前和术后患者的自我报告睡眠质量,并探讨睡眠质量是否因 AF 严重程度或性别而异。
这项纵向试点研究使用匹兹堡睡眠质量指数(PSQI)在消融术前和术后 1、3 和 6 个月评估睡眠质量。采用加拿大心脏病学会房颤严重程度量表评估 AF 严重程度。使用描述性统计、斯皮尔曼 ρ 相关分析和多层次纵向模型分析结果。
样本(N=20)中 55%为女性,平均年龄为 65(±7)岁。所有时间点均存在睡眠质量差(PSQI 评分>5)。术后 3 个月有改善(中等效应量 d=0.49);从术后 3 个月到 6 个月,仅有轻微的进一步改善。改善主要见于男性(术后 3 个月时的效应量 d=0.89),女性改善较小。尽管房颤严重程度量表评分与睡眠质量无相关性,但房颤严重程度量表严重程度评分随时间推移确实有所改善。
AF 患者睡眠质量较差,AF 消融术后 3 个月内睡眠质量有所改善,男性改善程度大于女性。更准确地了解 AF 消融术后的睡眠挑战可能会导致制定更现实的患者教育并改善患者自我管理。