Quality of life in pediatric patients affected by electrophysiologic disease. Heart Rhythm 2015 May;12(5):899-908
Date
01/21/2015Pubmed ID
25602174DOI
10.1016/j.hrthm.2015.01.022Scopus ID
2-s2.0-84928611311 (requires institutional sign-in at Scopus site) 24 CitationsAbstract
BACKGROUND: Treatment of electrophysiologic (EP) disease in pediatric patients has improved; however, the effects on quality of life (QOL) are unknown.
OBJECTIVE: The purpose of this study was to compare QOL within EP disease groups and to other congenital heart diseases, to evaluate the effects of cardiac rhythm devices on QOL, and to identify drivers of QOL in EP disease.
METHODS: Cross-sectional study of patient/parent proxy-reported Pediatric Cardiac Quality of Life Inventory scores (Total, Disease Impact, Psychosocial Impact) in subjects aged 8 to 18 years from 11 centers with congenital complete heart block (CCHB), ventricular tachycardia (VT), supraventricular tachycardia (SVT), and long QT syndrome (LQTS). QOL was compared between EP disease groups and congenital heart disease groups [bicuspid aortic valve (BAV), tetralogy of Fallot (TOF), and Fontan]. General linear modeling was used to perform group comparisons and to identify predictors of QOL variation.
RESULTS: Among 288 patient-parent pairs, mean age was 12.8 ± 3.0 years. CCHB (μ = 83) showed higher patient Total QOL than other EP disease cohorts (P ≤ .02; LQTS μ = 73; SVT μ = 74). SVT (μ = 75) and LQTS (μ = 75) had lower patient Total scores than BAV (μ = 81; P ≤ .008). Patient/parent-proxy QOL scores for all EP disease groups were not different than TOF and higher than Fontan. The presence of a cardiac rhythm device was associated with lower QOL scores in LQTS (μ = 66 vs μ = 76; P < .01). Predictors of lower patient/parent-proxy QOL included EP disease type (P ≤ .03), increased medical care utilization (P ≤ .04), and no parental college degree (P ≤ .001).
CONCLUSION: Given the significant variation in QOL in EP disease type, stratification by EP disease type and increased medical care utilization may allow for targeted interventions to improve QOL.
Author List
Czosek RJ, Cassedy AE, Wray J, Wernovsky G, Newburger JW, Mussatto KA, Mahony L, Tanel RE, Cohen MI, Franklin RC, Brown KL, Rosenthal D, Drotar D, Marino BSAuthor
Kathleen Mussatto Ph.D. Associate Professor in the School of Nursing department at Milwaukee School of EngineeringMESH terms used to index this publication - Major topics in bold
AdolescentArrhythmias, Cardiac
Child
Cross-Sectional Studies
Defibrillators
Female
Heart Defects, Congenital
Heart Rate
Humans
Linear Models
Male
Pacemaker, Artificial
Pediatrics
Quality of Life
United Kingdom
United States