RESUMO
BACKGROUND: Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice, and has major impact on health-related quality of life, thus, there is a need for a specific instrument to assess AF symptoms and quality of life. METHODS: We developed and validated a specific questionnaire for quality of life in AF patients (QLAF) based on clinical manifestations (palpitation, breathlessness, dizziness and chest pain), and the usual treatments (medication, cardioversion and ablation). For validation, the new questionnaire was compared with the generic SF-36 questionnaire. Reproducibility was tested using 40 questionnaires administered by two different observers at distinct times and places. Responsiveness was evaluated based on variation of the QLAF score over time. RESULTS: There were a total of 462 questionnaires (231 SF-36 and 231 QLAF) administered at baseline, 3, 6, 9 and 12 months. Construct validity was demonstrated by the negative correlation between QLAF and SF-36 scores that was observed over the follow-up period. Analysis of internal consistency for reproducibility showed excellent Cronbach's alpha coefficients (inter- and intraobserver coefficients of 0.98 and 0.96, respectively). QLAF was responsive as indicated by significant differences in mean domain scores from the beginning to the end of follow-up. It took much less time to administer the QLAF than the SF-36 (3:08±0:33 min vs. 9:25±1:14 min, p<0.001). CONCLUSION: The QLAF questionnaire is easy to understand and can be administered rapidly in the outpatient setting. Furthermore, the QLAF score is valid and reproducible and responsive to a change in clinical status.
Assuntos
Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/psicologia , Psicometria/normas , Qualidade de Vida , Inquéritos e Questionários/normas , Idoso , Antiarrítmicos/uso terapêutico , Fibrilação Atrial/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Psicometria/estatística & dados numéricos , Reprodutibilidade dos TestesRESUMO
As arritmias freqüentemente complicam o manuseio da insuficiência cardíaca e contribuem para o aumento de sua morbidade e mortalidade. A incidência de fibrilação atrial aumenta proporcionalmente à gravidade da insuficiência cardíaca. A anticoagulação e o controle da freqüência cardíaca são importantes, e a estratégia de manutenção do ritmo sinusal ainda não se mostrou superior à do controle da freqüência. O implante dos cardioversores-desfibriladores-implantáveis constitui atualmente a forma mais efetiva de prevenção contra a morte súbita; porém, provavelmente, seu benefício é inferior nos portadores de insuficiência cardíaca em relação à população dos estudos com desfibriladores. A amiodarona é a opção farmacológica mais importante para o tratamento de arritmias sintomáticas nessa população.
