Women with PSVT are often misdiagnosed, referred later than men, and have more symptoms after ablation

作者:Carnlof Carina*; Iwarzon Marie; Jensen Urstad Mats; Gadler Fredrik; Insulander Per
来源:Scandinavian Cardiovascular Journal, 2017, 51(6): 299-307.
DOI:10.1080/14017431.2017.1385837

摘要

Objectives. Using a patient and gender perspective, this study evaluates the experiences and perspectives of referral for paroxysmal supraventricular tachycardia (PSVT), and symptoms, Health-Related Quality of Life (HRQOL) and functional impairment before and six months after ablation. Design. This prospective study includes 214 (109 women) patients with PSVT who completed questionnaires before and after ablation addressing referral patterns, duration of arrhythmia, socioeconomic status, symptoms, HRQOL, and functional impairment. Result. Women had a longer history of symptomatic arrhythmia before ablation compared to men (16.2 +/- 14.6 vs. 9.9 +/- 13.1 years, p=.001). From the patient's perspective, physicians more often incorrectly interpreted women's symptoms as anxiety, stress, panic attacks, or depression compared to men, delaying referral for ablation. More women than men stated they were not taken seriously when consulting for their tachycardia symptoms (17% vs.7%, p=.03). At baseline, there were minor differences between the sexes in HRQOL and functional impairment, but women had a higher symptom score on Symptoms Checklist Frequency (19 vs. 14, p<.001) and Severity Scale (12 vs. 16, p=.001). At six months, women were more symptomatic and their HRQOL improved less than in men. Both sexes reported improvement in recreation and pastime (p=.001). Conclusion. Women with PSVT are referred for ablation later, and are more symptomatic before and after ablation than men. Symptoms due to PSVT are often incorrectly diagnosed as panic attacks, stress, anxiety, or depression, misdiagnoses that delay referral for ablation, especially for women.