Symptomatic improvement after catheter ablation of supraventricular tachycardia measured by the arrhythmia-specific questionnaire U22

Abstract

IntroductionThe main indication for ablation of supraventricular tachycardia is symptomatic relief. Generic measures of quality of life are not suitable for direct evaluation of arrhythmia-related symptoms, and a specific tool is needed. The questionnaire U22 quantifies symptoms associated with arrhythmic events. It uses discrete 0–10 scales for quantification of influence of arrhythmia on well-being, intensity of discomfort, type of dominant symptom, and a time aspect that summarizes duration and frequency of spells. We evaluated U22 in a well defined group of patients with paroxysmal supraventricular tachycardia, undergoing an intervention with a distinct end-point and a high success rate.MethodsSymptoms in patients with accessory pathway and atrioventricular nodal re-entrant tachycardia scheduled for ablation were measured with U22 and SF-36 on admission. The evaluation was repeated after 6 months.ResultsAltogether 58 patients successfully ablated in 2006–2008 completed the four forms (U22 and SF-36 at base-line and follow-up, 210 ± 35 days after ablation). The score for well-being (0–10; 10 being best) increased from 5.9 ± 2.6 to 7.9 ± 1.9 (P < 0.0005). The score for arrhythmia as cause for impairment in well-being (0–10; 10 being highest) decreased from 7.5 ± 2.8 to 2.0 ± 3.1 (P < 0.0005). The time aspect score (0–10) decreased from 4.7 ± 1.5 to 1.4 ± 1.8 (P < 0.0005). The two SF-36 summary measures PCS and MCS increased from 46.9 ± 9.4 to 48.4 ± 10.7 and from 44.9 ± 12.5 to 49.1 ± 9.9 (P = 0.04 and 0.002).ConclusionAfter successful ablation of accessory pathway and atrioventricular nodal re-entrant tachycardia, the U22 protocol detected a relevant increase in arrhythmia-related well-being. Modest improvement in general well-being was detected by the SF-36 protocol.

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary

“…18 In comparison with AVRT, patients with AVNRT are more likely to be female, with an age of onset >30 years. 16,[19][20][21] SVT has an impact on quality of life, which varies according to the frequency of episodes, the duration of SVT, and whether symptoms occur not only with exercise but also at rest. 18,22 In 1 retrospective study in which the records of patients <21 years of age with WPW pattern on the ECG were reviewed, 64% of patients had symptoms at presentation, and an additional 20% developed symptoms during follow-up.…”

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

“…Importantly, the intergroup differences were confirmed by the multivariate analyses. It is worth mentioning that previously published studies have also documented a statistical superiority of RF ablation over pharmacotherapy in improving quality of life indices [ 9 , 13 , 26 , 32 – 35 ]; however none of those reported any measures assessing the existence of clinically significant differences. In addition, to our knowledge, this is the first study showing that patients in the medical control group may even exhibit a deterioration in SF-36 indices in such a short time period.…”

“…The U22 questionnaire was developed for the assessment of symptoms associated with supraventricular tachycardia and includes a total of 22 questions [ 13 ]. Questions (Q) concerning general well-being (Q01), effectiveness (Q04) and side-effects (Q05) of pharmacotherapy, the influence of arrhythmia on well-being (Q11), the intensity of discomfort (Q12), and the severity of specific symptoms during a spell (Q13-Q22) are answered on a numerical rating scale with a range of 0-10, with higher scores reflecting a better feeling (Q01) or a more pronounced impact.…”

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

“…From the researchers' point of view, the more episodes of SVT, the more impaired they are to do their daily tasks, more visits to the emergency room, and a decrease in their daily activity level. Furthermore, the longer the duration of SVT episodes, the more impaired the roles that rely on physical health and physical functioning and the feeling of being afraid and thinking about the attack, all of which may impact QoL in these SVT patients [ 33 ].…”