摘要
目的通过观察患者生活质量变化来探讨环肺静脉消融术治疗阵发性心房颤动（房颤）对生活质量的影响。方法阵发性房颤患者接受经导管环肺静脉消融术，于消融术前和术后6个月，应用超声心动图测量患者左心房内径（LAd）和舒张晚期跨二尖瓣血流峰速（A峰）；用SF-36量表及症状列表评估患者生活质量和症状严重程度。结果2004年1月至2007年1月共有130例阵发性房颤患者接受环肺静脉消融术治疗。平均随访1．8（1～4）年，110例（84．6％）无房性心律失常发作，其中101例未服用抗心律失常药物。消融术后6个月，LAd由术前（38．6±3．3）mm缩小为（33．7±2．6）mm（P〈0．05），A峰由术前（0．68±0．15）m／s升高至（0．76±0．19）m／s（P〈0．05）。患者射频消融术后6个月的生活质量与术前比较，SF-36量表的8个维度中，躯体功能、躯体角色、社会功能、情感角色、活力有明显提高（P〈0．05），而肌体疼痛、心理健康、总的健康状况方面的变化差异无统计学意义（P〉0．05）。消融术后心悸、心动过速、活动受限症状减轻（P〈0．05），而呼吸困难、胸痛、头晕无明显变化（P〉0．05）。从治疗结果分析，治愈组和总体改变一致，复发组虽然心悸和心动过速症状减轻（P〈0．05），但生活质量的8个维度均没有变化。结论阵发性房颤患者接受环肺静脉消融术治疗后生活质量提高，同时伴左心房缩小和功能改善，其生活质量提高得益于房颤的治疗。
Objective To investigate the effects of circumferential pulmonary vein ablation（CPVA） on quality of life（QOL） in patients with paroxysmal atrial fibrillation（AF）. Methods One hundred and thirty patients with paroxymal AF underwent CPVA. Transthorax echocardiography was performed before and 6 months after the procedure. Left atrial dimension（LAd） and late diastolic peak velocity of mitral valve inflow（A） were recorded. QOL was assessed by Medical Outcomes Study Short Form-36 （SF-36） and Symptom Checklist at baseline and 6-month after CPVA. Results After a mean follow-up of 1.8 year, 110 patients （ 84. 6% ） were free from atrial tachyarrhythmias ,including 101 patients who were not taking antiarrhythmic drugs. As compared with the baseline, LAd decreased [ （38.6 ±3.3）mm vs （33.7 ±2. 6）mm] and A velocity increased [ （0. 68 ±0. 15）m/s vs （0. 76 ±0. 19）m/s） ] remarkably 6 months after CPVA（P 〈0. 05）. Of all 8 subscale measured with SF-36, the scores of physical functioning, role physical, role social, role emotional and vitality increased after CPVA（ P 〈 0.05 ） , and those of bodily pain, mental health and general health did not change significantly （ P 〉 0. 05 ）. The symptoms of palpitation, heart racing and limitation of activity decreased as compared with the baseline （P 〈 0. 05 ）. In subgroup analysis, similar changes as described above were found in patients with successful outcome. In patients atrial tachyarrhythmias recurred, although symptoms of palpitation and heart racing decreased, no significant change was found in QOL. Conclusions The symptoms and QOL in patients with paroxymal AF can be improved after CPVA accompanied by the improvement of LA size and functional parameters, and the QOL improvement is achieved by radical curing of AF.
出处
《中华心律失常学杂志》
2008年第5期374-377,共4页
Chinese Journal of Cardiac Arrhythmias
关键词
心房颤动
肺静脉
射频导管消融
生活质量
Atrial fibrillation
Pulmonary veins
Radiofrequeney catheter ablation
Quality of life
