Impact of Radiofrequency Ablation and Antiarrhythmic Medications on the Quality of Life of Patients with Supraventricular Tachycardias: Preliminary Validation of the Greek Version of the Umea22 (U22) Questionnaire

Abstract

Objective This study aims to (i) translate, culturally adapt, and preliminarily validate the arrhythmia-specific Umea22 (U22) questionnaire and (ii) assess the impact of radiofrequency (RF) ablation and medical treatment on the quality of life of patients with supraventricular tachycardias (SVTs). Methods A total of 140 patients with atrioventricular nodal re-entry tachycardia (AVNRT) and atrioventricular re-entry tachycardia (AVRT) were enrolled in the study. Of these, 100 patients underwent RF ablation (group A) and 40 patients were managed with antiarrhythmic medications (group B). Health-related quality of life (HRQoL) was assessed for both groups using the Short Form-36 Health Survey (SF-36) and the arrhythmia-specific Umea22 (U22) questionnaire at baseline and 3-month follow-up. Exploratory and confirmatory factor analyses were performed to assess the validity of the U22 questionnaire. Univariate comparisons of HRQoL scores between study timepoints and multivariate regression analyses adjusting for baseline confounders were conducted. Results The factor analysis of the U22 questionnaire yielded a six-factor model (“burden of spells”; “heart contractility”; “character of spells”; “general/non-specific feeling”; “other specific somatic symptoms”; “fear”) with acceptable fit results. Patients of group A showed significant improvement in all SF-36 and U22 scores at 3 months' follow-up compared to baseline (all p<0.05). Patients of group B presented deterioration of the total SF-36 score (p=0.001) and improvement of certain U22 measures, namely, well-being (p=0.004), heartbeat speed, and intensity during arrhythmia spells (p<0.0001 for both measures) at 3 months' follow-up, compared to baseline. Employment status, male sex, and urban residence emerged as important predictors. Conclusion The Greek version of the U22 questionnaire is a valid tool to assess SVT-related symptoms. RF ablation appears to exert more pronounced beneficial outcomes on HRQoL of patients with SVTs compared to medical treatment. Prompt referral of patients with SVTs to specialist centers may favorably affect their quality of life and should be encouraged.

Quality of life among patients with supraventricular tachycardia post radiofrequency cardiac ablation in Jordan

“…In this study, the QoL was assessed before and 1 month after the procedure, and there was a significant increase in all domains compared to baseline. This result is similar to previous studies [ 16 , 19 , 28 , 29 , 32 - 34 ]. These improvements were further confirmed by the outcomes of SF-36 measurements, according to which patients declared fewer symptoms, limited duration, and decreased frequency of episodes at the second measurement.…”

“…The result of this study was consistent with many studies that have similar characteristics to the present study [ 15 , 19 , 28 - 30 ]. Furthermore, the role limitation due to physical health and physical functioning showed the most significant decrease in mean score across all eight components in this study, which was also seen in most literature [ 16 , 28 , 31 ]. The rationale could be related to the patient’s fear that the episodes will come to them while working and they won't be able to complete the work and the usual daily tasks, and they may be forced to stop all their work.…”

“…Patients who suffer from recurrent and frequent arrhythmia episodes have a poor QoL after ablation because they never know when the next attack will occur. Many researchers reported similar results [ 13 , 16 , 29 , 31 , 34 ]. It might be expected to have a low QoL for patients with SVT related to recurrent episodes and long-term episodes.…”

“…On one hand, the results were in line with previous studies [ 33 , 36 ]. On the other hand, male sex was significantly associated with less QoL improvement than women after the Greek population's ablation procedure [ 16 ]. Also, the results of existing studies are discordant; researchers reported in Poland a higher severity of symptoms in the female sex compared to males, both at baseline and 2 months after the ablation [ 13 ].…”

“…Due to the abrupt recurring symptoms of patients with SVT, their QoL might be affected [ 14 , 15 ]. Most patients feel social isolation, postpone day-to-day tasks, have body pain, and decline in general health, whereas absence from work may exceed 12% in affected people [ 16 ].…”