Psychometric evaluation of the Polish version of the Arrhythmia‑Specific Questionnaire in Tachycardia and Arrhythmia: a new tool for symptom and health‑related quality of life assessment

Background: Atrial fibrillation (AF) is the most common arrhythmia resulting in hospitalization. The assessment of symptoms and health‑related quality of life (HRQoL) can provide valuable information before, during, and after health care interventions for AF. Aims: We aimed to perform a translation and cultural adaptation of the Arrhythmia‑Specific Questionnaire in Tachycardia and Arrhythmia (ASTA), and to evaluate the reliability and validity of its Polish version. Methods: The standard forward‑backward translation procedure to translate the ASTA questionnaire into Polish was used. A total of 244 patients with AF at a mean (SD) age of 70.7 (10.7) years completed the questionnaire and were included in the study. Reliability was tested using internal consistency (Cronbach α) and validity with an item‑total correlation, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). Results: The ASTA symptom scale had satisfactory psychometric properties (α = 0.718), and the corrected item‑total correlation was sufficient for most items (0.361–0.506), except for cold sweats (0.156). The ASTA HRQoL scale showed good psychometric properties (α = 0.855). Initial CFA analyses showed that the 1- and 2‑factor models had similar properties, with strong factor loadings and satisfactory goodness‑of‑fit values according to the comparative fit index (0.947 for the 1‑factor model vs 0.988 for the 2‑factor model). A comparison of the 1‑and 2‑factor models showed that the close fit for the root‑mean‑square error of approximation was better for the 2‑factor model (0.387 vs 0.193). A 2‑factor EFA model was produced, and for factor 1 (physical scale), the varimax low ranged between 0.470 and 0.804, and for factor 2 (the mental scale), it ranged between 0.597 and 0.873. Conclusions: The psychometric properties of the Polish version of the ASTA questionnaire were overall found to be satisfactory