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

Figures & data

Table I. Demographic data.

	Patients with all 4 forms (n = 63)		Patients with 1–3 missing forms (n = 78)
	AP	AVNRT	AP	AVNRT
n	26	37	35	43
Age mean (SD), years	43.9 (17.9)	57.1 (14.0)	42.3 (18.4)	53.3 (17.4)
Men, n (%)	17 (65)	14 (38)	27 (77)	18 (42)

All four requested forms (U22 and SF-36 at base-line and follow-up) were available from 63 of the 141 patients undergoing first-time ablations for AP or AVNRT. Five of the 63 ablations with complete data were not primarily successful, and these patients were subsequently excluded.

AP = accessory pathway; AVNRT = atrioventricular nodal re-entrant tachycardia.

Table II. U22 measures at base-line and follow-up.

	Question	Base-line	Follow-up	P (t test)
Well-being	q01	5.9 ± 2.6	7.9 ± 1.9	<0.0005
Arrhythmia events affecting well-being	q11	7.5 ± 2.8	2.0 ± 3.1	<0.0005
Discomfort during arrhythmia spell	q12	8.1 ± 2.2	2.3 ± 3.2	<0.0005
Symptom width^a		2.5 ± 1.7	0.9 ± 1.4	<0.0005
Intensity of dominant symptom		9.9 ± 0.3	3.9 ± 4.6	<0.0005
Incidence of symptoms	q08	2.5 ± 1.1	0.9 ± 1.3	<0.0005
Time aspect^b	q08, q10	4.7 ± 1.5	1.4 ± 1.8	<0.0005
Relevance score^a	q19	9.6 ± 1.5	9.5 ± 1.7	n.s.

Data from 58 first-time ablations, classified as primarily successful.

^aSee Appendix for definition.

^bSee Appendix and Table III for definition.

q01, q08, q10, q11, q12, q19 = U22 questions 1, 8, 10, 11, 12, 19.

Table III. Computation of the time aspect from the symptom duration and incidence scores.

			q08 How often
			Never	On rare occasions	A few times a month	A few times a week	Daily	All the time
			0	1	2	3	4	5
q10 How long	Seconds	0	0	1	2	3	4	5
	Minutes, less than a quarter of an hour	1	0	2	3	4	5	6
	A quarter of an hour to one hour	2	–	3	4	5	6	–
	One to four hours	3	–	4	5	6	7	–
	Longer	4	–	5	6	7	8	9
	All the time	5	–	–	–	–	9	10

The time aspect is found by looking up the row with relevant symptom duration score (q08) and column with relevant symptom incidence score (q10). For most combinations the time aspect is a simple addition of the two scores (both with range 0–5). The combination of incidence ‘never’ and duration ‘minutes’ is, however, assigned time aspect value 0. The entries marked as ‘–’ are coded as missing values as they correspond to largely inconsequent combinations of the two scores: Incidence ‘never’ with durations ‘a quarter of an hour’ or more; incidences ‘few times a week’ or less with duration ‘All the time’; incidence ‘All the time’ with durations ‘a quarter of an hour’ to ‘four hours’.

q08 = U22 question 8; q10 = U22 question 10.

Figure 1. SF-36 subscales. The figure shows the SF-36 profiles at base-line and follow-up, labelled with mean values of the eight subscales in the study group. For comparison, the profiles of an older and a recently published group of patients with SVTA (6,18) are shown (the mean values were derived from the published graph and the number of patients). At base-line, the present study group is very close to the recent material by Walfridsson et al. (18). The profile is similar, but at a higher absolute subscale level than in the older material of patients by Bubien et al. (6). This may reflect a development towards ablation in patients with fewer symptoms. (pf = physical functioning; rp = role-physical; bp = bodily pain; gh = general health; vt = vitality; sf = social functioning; re = role-emotional; mh = mental health; SVTA = supraventricular tachycardia.)

Table

1.	On the whole, how have you felt over the past month?	[Miserable–very well, 0–10]
	(2 – not applicable in base-line form)
3.	Do you take any prescribed medications for your heart rhythm problems?	[No; Yes]
4.	How effective is the medication(s) in treating your heart rhythm problems?	[Very much worse–very much better, 0–10]
5.	How much are you bothered by side-effects of the medication?	[Not at all–very much, 0–10]
	(6, 7 – not applicable in base-line form)
8.	How often do you experience problems with heart rhythm? (despite taking any medication)	[Never; Rarely; A few times a month; A few times a week; Daily; All the time]
9.	Do the spells start suddenly?	[No; Yes]
10.	How long does a spell usually last?	[Seconds; More than a minute but less than 15 min; 15 min to 1 hour; 1 to 4 hours; More than 4 hours; All the time]
11.	How much do the spells affect your well-being?	[Not at all–very much, 0–10]
12.	How bothered are you while you are experiencing a spell?	[Not at all–very much, 0–10]
13.	My heart beats extremely fast when I'm having a spell	[Not at all–very true, 0–10]
14.	My heart pounds very heavily when I'm having a spell	[Not at all–very true, 0–10]
15.	My heart beats very irregularly when I'm having a spell	[Not at all–very true, 0–10]
16.	I faint or feel extremely dizzy when I'm having a spell	[Not at all–very true, 0–10]
17.	I have terrible pain when I'm having a spell	[Not at all–very true, 0–10]
18.	I feel extremely tired when I'm having a spell	[Not at all–very true, 0–10]
19.	I feel like my skin itches all over when I'm having a spell	[Not at all–very true, 0–10]
20.	I feel extremely short of breath when I'm having a spell	[Not at all–very true, 0–10]
21.	I become very frightened when I'm having a spell	[Not at all–very true, 0–10]
22.	Someone close to me becomes very frightened when I'm having a spell	[Not at all–very true, 0–10]

Table

2.	Compared to the time before the treatment, do you now feel:	[Very much worse–very much better, 0–10]
6.	Have you experienced any problems with the heart rhythm after the treatment? (Please disregard the first 3 months after the treatment.)	[No; Yes, of the same type as before the treatment; Yes, of different type]
7.	How bothersome are the spells in comparison with those before the treatment?	[Very much more–very much less, 0–10]

Bubien RS, Knotts-Dolson SM, Plumb VJ, Kay GN. Effect of radiofrequency catheter ablation on health-related quality of life and activities of daily living in patients with recurrent arrhythmias. Circulation. 1996;94:1585–91.

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