Maria Hee Jung Park Frausing, Martijn Van De Lande, Dominik Linz, Harry J G M Crijns, Robert G Tieleman, Martin E W Hemels, Mirko De Melis, Ulrich Schotten, Mads Brix Kronborg, Jens C Nielsen, Isabelle Van Gelder, Michiel Rienstra
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Outcomes collected were healthcare utilisation, and quality of life assessed using the Atrial Fibrillation Severity Scale and EuroQol EQ-5D-5L questionnaires.</p><p><strong>Results: </strong>During 1 year of follow-up, 63 973 AF episodes were detected in 353 (85%) patients. The median AF burden was 0.7% (IQR 0.1-4.0%). AF ablation was performed more frequently in patients with intermediate-to-high AF burdens (>0.2%) (16.2% vs 5.9%, p=0.01) and longer AF episode duration (>1 hour) (15.8% vs 2.0%, p=0.01), whereas cardioversions were more frequent in patients with longer episode duration (>1 hour) (9.5% vs 0%, p=0.04) and intermediate (0.2-1.9%) (but not high) AF burdens (13.6% vs 4.2%, p=0.01). Patients with many episodes (>147) reported higher symptom severity (p=0.001). No differences in symptom severity nor in EQ-5D-5L scores according to AF burden or duration were observed.</p><p><strong>Conclusion: </strong>In patients with early paroxysmal AF, higher AF burden and longer episode duration were associated with increased rates of healthcare utilisation but not with symptoms and quality of life. 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引用次数: 0
摘要
背景：我们旨在评估无房颤病史的早期阵发性房颤患者的房颤负担、持续时间和发作次数与医疗利用率和生活质量之间的关系：在这项观察性队列研究中，我们纳入了 417 名阵发性房颤患者，他们均来自 "心房颤动再评估：高凝状态、电重塑和血管失稳在房颤进展中的相互作用"（RACE V）研究。患者接受为期一年的插入式心脏监护仪监测。收集的结果包括医疗利用率以及使用心房颤动严重程度量表和EuroQol EQ-5D-5L问卷评估的生活质量：在一年的随访中，353 名患者（85%）共发现 63 973 次房颤发作。房颤负荷中位数为 0.7%（IQR 0.1-4.0%）。中高房颤负荷（>0.2%）（16.2% vs 5.9%，P=0.01）和房颤发作持续时间较长（>1小时）（15.8% vs 2.0%，P=0.01）的患者更常进行房颤消融术，而发作持续时间较长（>1小时）（9.5% vs 0%，P=0.04）和中度（0.2-1.9%）（但非高度）房颤负荷（13.6% vs 4.2%，P=0.01）的患者更常进行心脏电复律术。发作次数多（>147 次）的患者症状严重程度较高（P=0.001）。根据房颤负担或持续时间的不同，症状严重程度和EQ-5D-5L评分均无差异：结论：在早期阵发性房颤患者中，较高的房颤负担和较长的发作持续时间与医疗保健使用率的增加有关，但与症状和生活质量无关。发作次数越多的患者症状越严重：NCT02726698。
Healthcare utilisation and quality of life according to atrial fibrillation burden, episode frequency and duration.
Background: We aimed to evaluate the association between atrial fibrillation (AF) burden, duration and number of episodes with healthcare utilisation and quality of life in patients with early paroxysmal AF without a history of AF.
Methods: In this observational cohort study, we included 417 patients with paroxysmal AF from the Reappraisal of Atrial Fibrillation: interaction between hyperCoagulability, Electrical remodelling and Vascular destabilisation in the progression of AF (RACE V) Study. Patients were monitored with an insertable cardiac monitor for 1 year. Outcomes collected were healthcare utilisation, and quality of life assessed using the Atrial Fibrillation Severity Scale and EuroQol EQ-5D-5L questionnaires.
Results: During 1 year of follow-up, 63 973 AF episodes were detected in 353 (85%) patients. The median AF burden was 0.7% (IQR 0.1-4.0%). AF ablation was performed more frequently in patients with intermediate-to-high AF burdens (>0.2%) (16.2% vs 5.9%, p=0.01) and longer AF episode duration (>1 hour) (15.8% vs 2.0%, p=0.01), whereas cardioversions were more frequent in patients with longer episode duration (>1 hour) (9.5% vs 0%, p=0.04) and intermediate (0.2-1.9%) (but not high) AF burdens (13.6% vs 4.2%, p=0.01). Patients with many episodes (>147) reported higher symptom severity (p=0.001). No differences in symptom severity nor in EQ-5D-5L scores according to AF burden or duration were observed.
Conclusion: In patients with early paroxysmal AF, higher AF burden and longer episode duration were associated with increased rates of healthcare utilisation but not with symptoms and quality of life. Patients with a higher number of episodes experienced more severe symptoms.
期刊介绍：
Heart is an international peer reviewed journal that keeps cardiologists up to date with important research advances in cardiovascular disease. New scientific developments are highlighted in editorials and put in context with concise review articles. There is one free Editor’s Choice article in each issue, with open access options available to authors for all articles. Education in Heart articles provide a comprehensive, continuously updated, cardiology curriculum.
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