心房颤动射频消融术对低CHA2DS2-VASc评分心房颤动患者生活质量的影响

Impacts of radiofrequency ablation on quality of life of atrial fibrillation patients with low CHA2DS2- VASc score

目的探讨单次心房颤动（房颤）射频消融术（RFA）对低CHA2DS2-VASc评分房颤患者的生活质量的影响。方法从中国房颤注册研究（TheChineseAtrialFibrillationRegistry，CAFR）中选取2011年到2013年间完成基线和6个月随访房颤生活质量评估量表（AFEQT）的367例CHA2DS2-VASc评分〈2分的房颤患者。采用倾向性评分匹配建立基线平衡的队列，对基线至6个月间生活质量变化进行组内和组间比较。结果经过倾向性评分匹配后，形成由44例经过RFA和61例未经过RFA（non-RFA）治疗的患者组成的105例房颤队列。RFA组和non-RFA组基线特点及基线AFEQT的各个维度均衡。除non-RFA组治疗满意度无显著改善外（基线至6个月变化为3．55分，P=0．13），两组其他维度和总分基线至6个月随访组内随访改善显著（RFA组基线至6个月变化均值：症状20．42分，日常活动17．1分，治疗焦虑20．36分，总分18．75分，治疗满意度9．66分；non-RFA组基线至6个月变化均值：症状14．66分；日常活动12．56分，治疗焦虑17．69分，总分14．71分；P值均〈0．05），但组间比较差异无统计学意义（P值均〉0．05）。结论基于倾向性匹配的队列，两组患者的基线生活质量平衡，6个月随访时除non-RFA组的治疗满意度外均有显著改善。然而，RFA相对于non-RFA未见显著优势。

Objective CHADS2 and CHA2DS2-VASc scores are two widely used systems for evaluating the risk of stroke in patients with atrial fibrillation （AF）. The Quality of life （QoL） after a single radiofrequency ablation （RFA） in AF patients with low CHADS2 score has been established. This study was designed to further explore the association between the QoL and AF patients with low CHA2DS2-VASc score after RFA. Methods We selected 367 AF patients with low CHA2DS2-VASc score （CHA2DS2-VASc 〈2） from the Chinese Atrial Fibrillation Registry （CAFR） between 2011 and 2013. They all completed both baseline and 6-month Atrial Fibrillation Effect on Quality-of-Life （AFEQT） questionnaires. Propensity score matching was used to construct a final cohort of 105 patients. They were divided into two groups： RFA group （n =44） and non-RFA group （n = 61 ）. Results Baseline clinic characteristics, and each domain and global score of AFEQT were comparable between the two groups. Except for domain of treatment satisfaction in non-RFA group （mean score change from baseline to 6-month： 3.55, P = 0. 13） , the other domains in this group （ mean score change from baseline to 6-month ： symptom, 14. 66 ; daily activities, 12. 56 ; treatment concern,17.69;global score, 14.71, all P 〈 0.05 ） and all the domains in RFA group improved greatly within-group comparison （mean score change from baseline to 6-month： symptom, 20.42; daily activities, 17.1 ; treatment concern, 20. 36; global score, 18. 75 ; treatment satisfaction, 9.66, all P 〈 0. 05 ） . Nosignificant differences were observed in all domains of baseline to 6-month changes between two groups （ all P 〉 0. 05）. Conclusions No significant changes could be viewed in QoL between RFA and non-RFA AF patients with low CHA2DS2-VASc score, whose baseline AFEQT were balanced, and QoL from baseline to 6-month improves significantly.