2023-07-12 カロリンスカ研究所(KI)
◆この研究は、他の治療法と比較してもAF特有のQoLへの影響が類似しており、治療後12か月間も持続していることを示しています。これは重要な成果であり、AF患者への追加治療法としてCBTを取り入れることが期待されます。
<関連情報>
- https://news.ki.se/cbt-improved-quality-of-life-in-patients-with-atrial-fibrillation
- https://www.sciencedirect.com/science/article/abs/pii/S073510972305550X?via%3Dihub
認知行動療法は症候性発作性心房細動患者のQOLを改善する Cognitive Behavioral Therapy Improves Quality of Life in Patients With Symptomatic Paroxysmal Atrial Fibrillation
Josefin Särnholm, Helga Skúladóttir, Christian Rück, Erland Axelsson, Marianne Bonnert, Maria Bragesjö, Ashwin Venkateshvaran, Eva Ólafsdóttir, Susanne S. Pedersen, Brjánn Ljótsson, Frieder Braunschweig
Journal of the American College of Cardiology Available online: 26 June 2023
DOI:https://doi.org/10.1016/j.jacc.2023.04.044
Abstract
Background
Atrial fibrillation (AF) is often associated with troubling symptoms leading to impaired quality of life (QoL) and high health care use. Symptom preoccupation, that is, fear of cardiac-related symptoms and avoidance behavior, potentially contributes to disability in AF but is not targeted by current interventions.
Objectives
We sought to evaluate the effect of online cognitive behavior therapy (AF-CBT) on QoL in patients with symptomatic paroxysmal AF.
Methods
Patients with symptomatic paroxysmal AF (n = 127) were randomly assigned to receive AF-CBT (n = 65) or standardized AF education (n = 62). Online AF-CBT lasted 10 weeks and was therapist guided. The main components were exposure to cardiac-related symptoms and reduction of AF-related avoidance behavior. Patients were evaluated at baseline, posttreatment, and at the 3-month follow-up. Primary outcome was AF-specific QoL as assessed by the Atrial Fibrillation Effect on Quality of Life summary score (range: 0-100) at the 3-month follow-up. Secondary outcomes included AF-specific health care consumption and AF burden assessed by 5-day continuous electrocardiogram recording. The AF-CBT group was followed for 12 months.
Results
AF-CBT led to large improvements in AF-specific QoL (Atrial Fibrillation Effect on Quality of Life summary score) by 15.0 points (95% CI: 10.1-19.8; P < 0.001). Furthermore, AF-CBT reduced health care consumption by 56% (95% CI: 22-90; P = 0.025). The AF burden remained unchanged. Results on self-assessed outcomes were sustained 12 months after treatment.
Conclusions
In patients with symptomatic paroxysmal AF, online CBT led to large improvements in AF-specific QoL and reduced health care use. If these results are replicated, online CBT may constitute an important addition to AF management. (Internet-Delivered Cognitive Behavior Therapy for Atrial Fibrillation; NCT03378349)
