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消融能量来源对心房颤动患者生活质量感知及症状的影响:一项比较研究。

Impact of Ablation Energy Sources on Perceived Quality of Life and Symptom in Atrial Fibrillation Patients: A Comparative Study.

作者信息

Matteucci Andrea, Russo Maurizio, Galeazzi Marco, Pandozi Claudio, Bonanni Michela, Mariani Marco Valerio, Pierucci Nicola, La Fazia Vincenzo Mirco, Di Fusco Stefania Angela, Nardi Federico, Colivicchi Furio

机构信息

Clinical and Rehabilitation Cardiology Division, San Filippo Neri Hospital, 00135 Rome, Italy.

Department of Experimental Medicine, Tor Vergata University, 00133 Rome, Italy.

出版信息

J Clin Med. 2025 Apr 16;14(8):2741. doi: 10.3390/jcm14082741.

DOI:10.3390/jcm14082741
PMID:40283571
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12028017/
Abstract

: Catheter ablation is a first-line treatment for rhythm control strategies in patients with atrial fibrillation (AF), with different energy sources available, including pulsed-field ablation (PFA), high-power short-duration radiofrequency (HPSD RF), conventional radiofrequency (RF), and cryoballoon ablation. Limited evidence exists on how different ablation techniques affect patient-reported outcomes, such as patients' quality of life (QoL) and perceived symptoms. This study aims to assess the impact of ablation energy sources on reported QoL and symptom perception after AF ablation. : The study included 148 patients who underwent catheter ablation in different centers. Patients were divided into four groups according to the energy source used. Follow-up was conducted during the 6 months post-procedure. Patients were asked to complete a 20-item questionnaire evaluating quality of life, activity resumption, recovery process, perceived symptoms, and satisfaction. Comparative analyses were performed across energy groups, anesthesia types, and anesthetic drugs. : PFA patients reported the highest improvement in QoL scores compared to RF, HPSD RF, and cryoablation ( < 0.001). Activity resumption and symptom relief were significantly better in the PFA group compared to others ( < 0.001). Anesthesia type and anesthetic drug influenced QoL outcomes, with patients under general anesthesia showing higher QoL scores compared to deep sedation ( < 0.001). The energy source and anesthetic drug resulted in independent predictors of QoL improvement. : Ablation energy source could impact patients' perceived QoL and symptom relief after AF ablation. PFA demonstrated superior performance scores in QoL and symptom perception compared to other techniques. Anesthetic drugs also play a role in patient-reported outcomes and activity resumption.

摘要

导管消融是心房颤动(AF)患者节律控制策略的一线治疗方法,有多种可用的能量源,包括脉冲场消融(PFA)、高功率短时射频(HPSD RF)、传统射频(RF)和冷冻球囊消融。关于不同消融技术如何影响患者报告的结局,如患者的生活质量(QoL)和感知症状,现有证据有限。本研究旨在评估消融能量源对AF消融后报告的QoL和症状感知的影响。

该研究纳入了148名在不同中心接受导管消融的患者。根据所使用的能量源将患者分为四组。在术后6个月进行随访。要求患者完成一份20项问卷,评估生活质量、活动恢复、恢复过程、感知症状和满意度。对能量组、麻醉类型和麻醉药物进行了比较分析。

与RF、HPSD RF和冷冻消融相比,PFA患者报告的QoL评分改善最高(<0.001)。与其他组相比,PFA组的活动恢复和症状缓解明显更好(<0.001)。麻醉类型和麻醉药物影响QoL结局,全身麻醉患者的QoL评分高于深度镇静患者(<0.001)。能量源和麻醉药物是QoL改善的独立预测因素。

消融能量源可能会影响AF消融后患者的感知QoL和症状缓解。与其他技术相比,PFA在QoL和症状感知方面表现出更高的分数。麻醉药物在患者报告的结局和活动恢复中也起作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c66/12028017/b2141d155746/jcm-14-02741-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c66/12028017/8a49d63fcd94/jcm-14-02741-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c66/12028017/b2141d155746/jcm-14-02741-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c66/12028017/8a49d63fcd94/jcm-14-02741-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c66/12028017/b2141d155746/jcm-14-02741-g002.jpg

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Medicina (Kaunas). 2024 Sep 28;60(10):1594. doi: 10.3390/medicina60101594.
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2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS).2024年欧洲心脏病学会(ESC)心房颤动管理指南,与欧洲心胸外科学会(EACTS)联合制定。
Eur Heart J. 2024 Sep 29;45(36):3314-3414. doi: 10.1093/eurheartj/ehae176.
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Factors Associated with Quality of Life among People with Atrial Fibrillation: Jordan Atrial Fibrillation Registry Study.
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2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.2024 年欧洲心脏节律协会/心律学会/亚太心脏节律学会/拉丁美洲心脏节律学会专家共识声明:导管和手术消融治疗心房颤动。
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