| Objective: A cross-sectional survey of quality of life,family function,anxiety,and depression in patients with atrial fibrillation(AF)diagnosed and treated from January 1,2021 to May 1,2022 in the Department of Cardiology and General Medicine of the Second Hospital of Lanzhou University was conducted,and analyze the influencing factors of quality of life,family function,anxiety,and depression.Meanwhile,To explore how catheter ablation and antiarrhythmic drugs(AAD)can lead to changes in quality of life,family function,anxiety,and depression in patients with symptomatic paroxysmal AF.To analyze the influencing factors of clinically significant changes in the overall quality of life in patients with symptomatic paroxysmal AF.Ultimately providing reference for improving the quality of life,family function,anxiety,and depression symptoms of patients with AF.Methods: Strictly following the inclusion and criteria,patients with AF who were admitted to the Department of Cardiology and General Medicine of Lanzhou University Second Hospital from January 1,2021 to May 1,2022 were selected as the study subjects.A questionnaire was designed to collect general information about the patients,and the AF Effect on Quality-of-life(AFEQT,including 4 dimensions of Symptoms,Treatment Concerns,Daily Activities,and Treatment Satisfaction),Family Assessment Device(FAD,including 7 dimensions of Problem Solving,Communication,Roles,Affective Responsiveness,Affective Involvement,Behavior Control,General Functioning),Family Adaptation,Partnership,Growth,Affection,Resolve(APGAR),Generalized Anxiety Disorder 7(GAD-7)and Patient Health Questionnaire 9(PHQ-9)were used to evaluate the quality of life,family function,anxiety and depression of patients.The higher the scores on the AFEQT and APGAR scales,the better their function,while the higher the scores on the FAD,GAD-7,and PHQ-9 scales,the worse their function.The patients were divided into good family function group and poor family function group according to the FAD score(based on120 points)for current status investigation.And patients with symptomatic paroxysmal AF were divided into catheter ablation group and AAD group according to different treatment strategies for clinical follow-up,and their quality of life,family function,anxiety,and depression levels were evaluated at baseline and after 6 months of clinical follow-up.Pearson linear correlation analysis was used to analyze the correlation among quality of life,family function,anxiety,and depression scores in patients with AF.A stepwise multiple linear regression model was constructed to analyze the influencing factors of quality of life,family function,anxiety,and depression,and a Logistic regression model was constructed to analyze the influencing factors of clinically significant changes in overall quality of life in patients with symptomatic paroxysmal AF.Results: 1.The current analysis of quality of life,family function,anxiety,and depression in patients with AF showed that the quality of life score was(59.85±6.82)points,which was at a relatively low level,the score of family function was(132.83±16.07)points,which was at a moderate level,the anxiety score was(6.10±2.53)points,and the depression score was(5.77±2.65)points,which were at a high level.Among 223 patients with AF,64(28.7%)belonged to good family function and 159(71.3%)belonged to poor family function.Compared with the poor family function group,the total score of quality of life(57.51±6.19 vs 65.65±4.47)in the good family function group was significantly higher(P<0.05),while the total scores of anxiety(6.35±2.60 vs 5.50±2.26)and depression(6.12±2.64 vs 4.91±2.47)were significantly lower(both P<0.05).2.Personal linear correlation analysis of quality of life,family function,anxiety,and depression scores in patients with AF showed that quality of life was negatively correlated with family function scores(-0.795<r<-0.260,P<0.05),and negatively correlated with anxiety and depression scores(-0.542<r<-0.199,P<0.05),family function was positively correlated with anxiety and depression scores(0.159<r<0.368,P<0.05).3.The stepwise multiple linear regression analysis of quality of life,family function,anxiety,and depression in patients with AF showed that the General Functioning of FAD,Affective Involvement,Role and Problem Solving scores,GAD-7scores,PHQ-9 scores,and gender were the main factors affecting the quality of life in patients with AF(P<0.05).Symptoms,Treatment Concerns and Daily Activities scores of AFEQT,residence,and educational level were the main factors affecting family function in patients with AF(P<0.05).PHQ-9 scores,gender,Treatment Concerns scores of AFEQT,Per capita monthly income of households,Affective Responsiveness scores of FAD,and whether combined heart failure were the main factors affecting anxiety in patients with AF(P<0.05).Treatment Concerns and Daily Activities scores of AFEQT,GAD-7 scores,gender were the main factors affecting depression in patients with AF(P<0.05).4.Evaluating the impact of different treatment strategies on quality of life,family function,anxiety,and depression in patients with symptomatic paroxysmal AF showed that compared with the AAD group,the quality of life(60.81±6.63 vs 76.30±6.86),family function(5.67±2.38 vs 8.01±2.13),anxiety(6.36±2.62 vs 4.98±2.58),and depression level(5.39±2.89 vs 4.45±3.52)in the catheter ablation group were significantly improved(all P<0.05).5.The analysis of influencing factors of clinically significant changes in the overall quality of life of patients with symptomatic paroxysmal AF found that patients undergoing catheter ablation(OR=233.20,95% CI: 58.51-929.43,P=0.001)had a clinically significant increase,and patients with merging diabetes(OR=0.10,95% CI:0.02-0.50,P=0.005)had a clinically significant decrease or unchanged,patients with AF lasting for more than 5 years(OR=3.32,95% CI: 1.13-9.74,P=0.029)or using antiarrhythmic drugs(OR=38.74,95% CI: 12.25-122.49,P=0.001)had a clinically significant decrease.Conclusions: 1.There was a high correlation among the quality of life,family function,anxiety,and depression levels in patients with AF,which can be effectively predicted from each other.Patients with impaired quality of life had significantly poorer family function,and symptoms of anxiety and depression were significantly increased.2.General demographic and clinical characteristics of diseases can also have an impact on the quality of life,family function,anxiety,and depression levels of patients with AF.Compared to men,women with AF had significantly impaired quality of life,and generally suffered from anxiety and depression symptoms.Per capita monthly income of households and whether combined heart failure also had an impact on anxiety symptoms.In addition to the AFEQT scores,residence and educational level were also the main factors affecting family function in patients with AF.3.Compared to AAD,catheter ablation can effectively improve the quality of life,family function,anxiety,and depression symptoms of patients with symptomatic paroxysmal AF.Moreover,patients undergoing catheter ablation had a clinically significant increase of the overall quality of life,mainly due to the relief of symptoms and reduced burden of AF. |
