Patho-specific assessment of the quality of life using the ASTA protocol after radiofrequency ablation for atrial tachyarrhythmias
DOI:
https://doi.org/10.14739/2310-1210.2024.1.288485Keywords:
supraventricular tachyarrhythmias, quality of life, ASTA questionnaire, psycho-emotional state, comorbidity, anxiety, radiofrequency ablation, cavo-tricuspid isthmus, symptom, subjective health complaintAbstract
Atrial tachyarrhythmias cause highly symptomatic conditions and have a negative impact on the patients’ quality of life (QoL). In the management of such patients, it is particularly important to consider not only objective indicators, but also the subjective well-being of patients and their everyday life. The patho-specific questionnaire for assessing the QoL is the ASTA symptom scale.
The aim of the work was to conduct a patho-specific assessment of the QoL using the ASTA protocol after radiofrequency ablation (RFA) for atrial tachyarrhythmias on the example of performed cavo-tricuspid isthmus (CTI) RFA among patients with typical atrial flutter.
Materials and methods. In total, 135 patients from the National Amosov Institute of Cardiovascular Surgery were asked to complete the ASTA questionnaire before CTI RFA and during two follow-up visits in the period from 2014 to 2021. To assess the patients’ QoL, a statistical analysis was performed in accordance with the 6th part of chapters 2 and 3.
Results. When analyzing complaints, statistically significant changes were found in all aspects compared to the initial state (p < 0.05). The most noticeable changes were related to the anxiety level and heart failure manifestations, in particular, dyspnea on exertion and at rest, weakness and exhaustion (p < 0.0001). The least but also statistically significant changes were associated with comorbid pathologies. Analyzing the third chapter, positive statistically significant dynamics were observed in all characteristics during the control period.
After RFA, the patients reported improvements in their QoL, decreased level of depression and restored physical activity (p < 0.0001). There was also a significant improvement in social life, as there were no more restrictions in spending time with relatives and friends (p < 0.0001). In addition, there was an improvement in the ability to concentrate and in the working capacity (p < 0.0001).
Conclusions. Atrial tachyarrhythmias significantly affect the QoL of patients, including their emotional, physical state and social integration, worsening the daily lives of the study participants.
References
Lomper K, Sławuta A, Dudek K, Mazur G, Walfridsson U, Jankowska-Polańska B. Psychometric evaluation of the Polish version of the Arrhythmia Specific Questionnaire in Tachycardia and Arrhythmia: a new tool for symptom and health related quality of life assessment. Kardiol Pol. 2019;77(5):541-52. doi: https://doi.org/10.5603/KP.a2019.0046
Nordblom AK, Boysen GN, Berglund M, Kjellsdotter A. Health care centre and emergency department utilization by patients with episodes of tachycardia. BMC Cardiovasc Disord. 2022;22(1):124. doi: https://doi.org/10.1186/s12872-022-02568-y
Cannavan PM, Cannavan FP, Walfridsson U, Lopes MH. Translation and Validation of the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia (ASTA) to the Brazilian Context: An Instrument Focusing on Arrhythmia Symptoms. Cardiol Res Pract. 2020;2020:1402916. doi: https://doi.org/10.1155/2020/1402916
Wood KA, Drew BJ, Scheinman MM. Frequency of disabling symptoms in supraventricular tachycardia. Am J Cardiol. 1997;79(2):145-9. doi: https://doi.org/10.1016/s0002-9149(96)00701-1
Cleeland CS. Symptom burden: multiple symptoms and their impact as patient-reported outcomes. J Natl Cancer Inst Monogr. 2007;(37):16-21. doi: https://doi.org/10.1093/jncimonographs/lgm005
Randolph TC, Simon DN, Thomas L, Allen LA, Fonarow GC, Gersh BJ, et al. Patient factors associated with quality of life in atrial fibrillation. Am Heart J. 2016;182:135-43. doi: https://doi.org/10.1016/j.ahj.2016.08.003
Pequeno NP, Cabral NL, Marchioni DM, Lima SC, Lyra CO. Quality of life assessment instruments for adults: a systematic review of population-based studies. Health Qual Life Outcomes. 2020;18(1):208. doi: https://doi.org/10.1186/s12955-020-01347-7
Stridsman M, Strömberg A, Hendriks J, Walfridsson U. Patients' Experiences of Living with Atrial Fibrillation: A Mixed Methods Study. Cardiol Res Pract. 2019;2019:6590358. doi: https://doi.org/10.1155/2019/6590358
Ulla W, Anna S, Årestedt K. Development and validation of an arrhythmia-specific scale in tachycardia and arrhythmia with focus on health-related quality of life. J Cardiovasc Nurs. 2015;30(2):98-108. doi: https://doi.org/10.1097/JCN.0000000000000149
Jankowska-Polańska B, Kaczan A, Lomper K, Nowakowski D, Dudek K. Symptoms, acceptance of illness and health-related quality of life in patients with atrial fibrillation. Eur J Cardiovasc Nurs. 2018;17(3):262-72. doi: https://doi.org/10.1177/1474515117733731
Diamant MJ, Andrade JG, Virani SA, Jhund PS, Petrie MC, Hawkins NM. Heart failure and atrial flutter: a systematic review of current knowledge and practices. ESC Heart Fail. 2021;8(6):4484-96. doi: https://doi.org/10.1002/ehf2.13526
Li JH, Xie HY, Chen YQ, Cao ZJ, Tang QH, Guo XG, et al. Risk of New-Onset Atrial Fibrillation Post-cavotricuspid Isthmus Ablation in Typical Atrial Flutter Without History of Atrial Fibrillation. Front Physiol. 2021;12:763478. doi: https://doi.org/10.3389/fphys.2021.763478
Zahid S, Whyte KN, Schwarz EL, Blake RC 3rd, Boyle PM, Chrispin J, et al. Feasibility of using patient-specific models and the "minimum cut" algorithm to predict optimal ablation targets for left atrial flutter. Heart Rhythm. 2016;13(8):1687-98. doi: https://doi.org/10.1016/j.hrthm.2016.04.009
Cosío FG. Atrial Flutter, Typical and Atypical: A Review. Arrhythm Electrophysiol Rev. 2017 Jun;6(2):55-62. doi: https://doi.org/10.15420/aer.2017.5.2
Calkins H, Hindricks G, Cappato R, Kim YH, Saad EB, Aguinaga L, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm. 2017;14(10):e275-e444. doi: https://doi.org/10.1016/j.hrthm.2017.05.012
Fayers PM, Machin D. Quality of life : the assessment, analysis, and reporting of patient-reported outcomes. Chichester, West Sussex, Uk ; Hoboken, Nj: John Wiley & Sons Inc; 2016.
Streiner DL, Norman G. Health measurement scales: A practical guide to their development and use. 3rd ed. London, England: Oxford University Press; 2003.
Härdén M, Nyström B, Kulich K, Carlsson J, Bengtson A, Edvardsson N. Validity and reliability of a new, short symptom rating scale in patients with persistent atrial fibrillation. Health Qual Life Outcomes. 2009;7:65. doi: https://doi.org/10.1186/1477-7525-7-65
Parameswaran R, Al-Kaisey AM, Kalman JM. Catheter ablation for atrial fibrillation: current indications and evolving technologies. Nat Rev Cardiol. 2021;18(3):210-25. doi: https://doi.org/10.1038/s41569-020-00451-x
Vest BM, Quigley BM, Lillvis DF, Horrigan-Maurer C, Firth RS, Curtis AB, et al. Comparing Patient and Provider Experiences with Atrial Fibrillation to Highlight Gaps and Opportunities for Improving Care. J Gen Intern Med. 2022;37(12):3105-13. doi: https://doi.org/10.1007/s11606-021-07303-5
Darbar D, Roden DM. Symptomatic burden as an endpoint to evaluate interventions in patients with atrial fibrillation. Heart Rhythm. 2005;2(5):544-9. doi: https://doi.org/10.1016/j.hrthm.2005.01.028
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)