PDF(Pubmed)
Abstract：
OBJECTIVE: Thoracoscopic ablation has proven to be an effective and safe rhythm control strategy, especially for persistent atrial fibrillation. However, its impact on quality of life (QoL) and potential gender differences remains unclear.
METHODS: This prospective, single-centre observational study included consecutive patients with symptomatic atrial fibrillation undergoing thoracoscopic ablation. QoL was measured using the Short Form 36 (SF-36) and Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaires and longitudinal trend analysis including linear mixed models was used to assess gender-specific differences.
RESULTS: A total of 191 patients were included; mean age 63.9 ± 8.6 years, 61 (31.9%) women and 148 (77.5%) with non-paroxysmal atrial fibrillation. Women were older, more symptomatic and reported lower baseline QoL. AFEQT summary scores substantially improved after three months (relative increase 51.5% from baseline; P < 0.001) and persisted up to 1-year (57.2%; P < 0.001). Women showed substantial QoL improvement, which was comparable to men at 1 year. Distinct gender-related trajectories for AFEQT were observed. Women showed more often clinically important decline over time, yet AF recurrence and age were predictive factors in both men and women. Patients with AF recurrence also experienced QoL improvements, albeit to a lesser extent than those in sinus rhythm (61.3% vs 26.9%, P < 0.001), with no differences between men and women.
CONCLUSIONS: Thoracoscopic ablation for atrial fibrillation results in substantial QoL improvement and was comparable for men and women. Understanding sex-specific and age-related trajectories is important to further enhance patient-centred atrial fibrillation care.
METHODS: This prospective, single-centre observational study included consecutive patients with symptomatic atrial fibrillation undergoing thoracoscopic ablation. QoL was measured using the Short Form 36 (SF-36) and Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaires and longitudinal trend analysis including linear mixed models was used to assess gender-specific differences.
RESULTS: A total of 191 patients were included; mean age 63.9 ± 8.6 years, 61 (31.9%) women and 148 (77.5%) with non-paroxysmal atrial fibrillation. Women were older, more symptomatic and reported lower baseline QoL. AFEQT summary scores substantially improved after three months (relative increase 51.5% from baseline; P < 0.001) and persisted up to 1-year (57.2%; P < 0.001). Women showed substantial QoL improvement, which was comparable to men at 1 year. Distinct gender-related trajectories for AFEQT were observed. Women showed more often clinically important decline over time, yet AF recurrence and age were predictive factors in both men and women. Patients with AF recurrence also experienced QoL improvements, albeit to a lesser extent than those in sinus rhythm (61.3% vs 26.9%, P < 0.001), with no differences between men and women.
CONCLUSIONS: Thoracoscopic ablation for atrial fibrillation results in substantial QoL improvement and was comparable for men and women. Understanding sex-specific and age-related trajectories is important to further enhance patient-centred atrial fibrillation care.
摘要：
目的：胸腔镜消融已被证明是一种有效且安全的节律控制策略，尤其是持续性心房颤动。然而,其对生活质量和潜在性别差异的影响尚不清楚.
方法：这种前瞻性，单中心观察性研究纳入了连续接受胸腔镜消融术的有症状房颤患者.使用简短表格36（SF-36）和心房颤动对生活质量的影响（AFEQT）问卷测量生活质量，并使用包括线性混合模型的纵向趋势分析来评估性别差异。
结果：纳入191例患者；平均年龄63.9±8.6岁，61名（31.9%）女性和148名（77.5%）非阵发性房颤患者。女人年纪大了，症状较多，基线生活质量较低。AFEQT总分在三个月后显著改善（相对于基线增加51.5%；p<0.001），并持续1年（57.2%；p<0.001）。女性在1岁时的生活质量得到了实质性的改善，与男性相当。观察到AFEQT的不同性别相关轨迹。随着时间的推移，女性表现出更多临床上重要的衰退，然而房颤复发和年龄是男性和女性的预测因素.房颤复发患者的QoL也有所改善，尽管程度低于窦性心律患者(61.3%vs26.9%，p<0.001)，男女之间没有区别。
结论：胸腔镜消融术治疗心房颤动可显著改善患者的生活质量，且男性和女性具有可比性。了解性别特异性和年龄相关的轨迹对于进一步加强以患者为中心的心房颤动护理非常重要。
方法：这种前瞻性，单中心观察性研究纳入了连续接受胸腔镜消融术的有症状房颤患者.使用简短表格36（SF-36）和心房颤动对生活质量的影响（AFEQT）问卷测量生活质量，并使用包括线性混合模型的纵向趋势分析来评估性别差异。
结果：纳入191例患者；平均年龄63.9±8.6岁，61名（31.9%）女性和148名（77.5%）非阵发性房颤患者。女人年纪大了，症状较多，基线生活质量较低。AFEQT总分在三个月后显著改善（相对于基线增加51.5%；p<0.001），并持续1年（57.2%；p<0.001）。女性在1岁时的生活质量得到了实质性的改善，与男性相当。观察到AFEQT的不同性别相关轨迹。随着时间的推移，女性表现出更多临床上重要的衰退，然而房颤复发和年龄是男性和女性的预测因素.房颤复发患者的QoL也有所改善，尽管程度低于窦性心律患者(61.3%vs26.9%，p<0.001)，男女之间没有区别。
结论：胸腔镜消融术治疗心房颤动可显著改善患者的生活质量，且男性和女性具有可比性。了解性别特异性和年龄相关的轨迹对于进一步加强以患者为中心的心房颤动护理非常重要。
